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Hundred Public Library
Online Registration for Library Card
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* Indicates required question
First Name
*
Your answer
Middle Name
Your answer
Last Name
*
Your answer
Type of Card
*
Adult (18+)
Youth (age 13-17; no guardian signature, limited checkouts)
Youth (age 13-17; with guardian signature, full priviledges)
Children's Card (age birth-12)
Birth Date (MM/DD/YEAR)
*
MM
/
DD
/
YYYY
Home Phone
*
Your answer
Cell Phone
Your answer
Physical Address (street, town, state, zip code):
*
Your answer
Mailing Address (PO Box or street, town, state, zip code)
*
Your answer
Email Address:
Your answer
Re-enter Email Address
Your answer
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