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Library Card Application for Rocky Hill Students
Cora J. Belden Library
33 Church St.
Rocky Hill, CT 06067
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* Indicates required question
Age:
*
Your answer
Birth Date:
*
MM
/
DD
/
YYYY
First Name:
*
Your answer
Last Name:
*
Your answer
Home Address:
*
Your answer
Address 2: (if different than above)
Your answer
Phone:
*
Your answer
Phone 2:
Your answer
School:
*
Choose
Stevens
West Hill
Moser
GMS
RHHS
E-Mail Address (please do not use your school ‘rockyhillps’ address): By providing your email address, you agree to receive notification of holds and overdues via email.
Your answer
Do you wish to receive our e-mail newsletter, which contains information on upcoming programs, online services, and happenings at the library?
*
Yes
No
Do you wish for us to set up your online PIN for access to your account on our online catalog (
https://lci-mt.iii.com/
)?
*
Yes
No
If you answered yes to the above question, please enter your preferred PIN below. It must be a minimum of 4 digits and no repeating patterns.
Your answer
Signature: (typing your signature will substitute for a written signature)
*
Your answer
Parent's Signature: (typing your signature will substitute for a written signature)
*
Your answer
If you have any questions, please enter them below or give us a call at the Information Desk, 860-258-7623.
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