Library Card Request Form

Select your branch(Required)

Limoges

St-Albert

St-Isidore

Personal Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Sex/Gender

Other

Birth Date (MM/DD/YYYY)(Required)

Address(Required)

Street Address Town / Village Province Postal Code Country

Are you a resident of The Nation Municipality?(Required)

Yes

Municipality(Required)

Consent & Signature

Are you under 16 years of age?(Required)

Yes

Name of parent or guardian

First Last

Signature of Parent or Guardian

By signing, I confirm that I am the parent or guardian of the applicant and accept responsibility for their use of The Nation Public Library, including ensuring they follow all Library rules and guidelines.

Signature of applicant

By signing, I confirm that I will follow the rules and guidelines of The Nation Municipality Public Library.

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