Library & Information Services
Library User Registration Form
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Surname (as appears on Student / Staff ID) *
Other names (as appears on Student / Staff ID) *
Student Registration / Staff Number *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
ID Barcode Number (Check back of Student / Staff ID) Cross-check to ensure accuracy. *
Date of Expiry of Student's ID *
MM
/
DD
/
YYYY
User Category *
Faculty *
Campus *
Student / Staff email address *
Personal postal address *
City / Town *
Mobile Phone Number *
Alternative Phone Number
Do you have any physical limitations that may require special facilities or assistance in-order to use the library? E.g. visual or physical impairment *
If "Yes" to the above question, kindly provide details.
Kindly confirm that the details provided above are all true & accurate? *
Submit
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