Organization card - Elkhart Public Library

Organization Name*

Preferred Language*

English
Spanish

Organization Address*

Street Address Apartment / Lot / Unit City State / Province / Region ZIP / Postal Code

Email*

Phone*

The best number at which to reach you. If you wish to receive notifications via text, please list your cell phone number here.

Notice Preference*

Email
Phone call
Text message

Standard text messaging rates may apply based on your plan with your mobile phone carrier. Text message delivery is subject to your mobile carrier network availability, so delivery is not guaranteed. You may opt out of text delivery at any time by replying STOP to any text message from Elkhart Public Library

Cell Carrier*

If you have selected text messaging as the preferred method of communication, we need to know which carrier through which to send the message.

Preferred Location for Card Pickup*

Please select a convenient location from which to pick up your Elkhart Public Library card. Please visit MyEPL.org/locations for more information about our sites.

Downtown, 300 S. Second St.
Cleveland, 53715 C.R. 1
Dunlap, 58485 C.R. 13
Osolo, 3429 E. Bristol St.
Pierre Moran, 2400 Benham Ave.
Delivery – we’ll bring it to you. Find out more and sign up at MyEPL.org/delivery. Some exclusions may apply – must provide Proof of Residency below when submitting this form.

Proof of Residency

Please note: If you choose not to attach documents here, you will need to bring those with you when you pick up your card. Elkhart Public Library requires identification to fulfill card requests. The information supplied must have an address matching the information provided on this form. Acceptable identification must include official organization letterhead with the names of the employees allowed to use the card.

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB, Max. files: 2.

Proof of Residency – Delivery*

Please note: If you choose not to attach documents here, you will need to bring those with you when you pick up your card. Elkhart Public Library requires identification to fulfill card requests. The information supplied must have an address matching the information provided on this form. Acceptable identification must include official organization letterhead with the names of the employees allowed to use the card.

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB, Max. files: 2.

Consent*

I agree to the following library cardholder terms.

By checking this consent box, I acknowledge the information provided on this form is true and accurate. Additionally:

• I agree to use my library card and only my library card.
• I agree to the care and return of all library materials borrowed on the card.
• I agree to pay fees for any damaged, missing or lost library materials.
• I agree to report immediately changes in my address, email and/or phone number.
• I agree to report immediately if my library card is lost.
• I agree to abide by the Elkhart Public Library Code of Conduct and observe all Elkhart Public Library policies, procedures, rules and regulations.

Electronic Signature of Cardholder*

This field serves as your signature for online registration.

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Organization Card Registration