Online User Registration

Title:

Personal Information

First Name:

Middle Name:

Last Name:

ID/Passport number:

Date of Birth:

Home language

Employment status

Category 3:

Suffix:

Preferred Name:

E-mail Address:

Verify E-mail Address:

Phone Number:

Zip Code:

Street Address:

Home Address

Street Address:

References/Contacts

Name and surname

Contact 1 address

Contact 1 Suburb

Contact 1 Postal

Contact 1 Phone

Name and surname

Contact 2 address

Contact 2 Suburb

Contact 2 Postal

Contact 2 Phone

Street Address:

Town:

City:

State:

City, State:

Preferred library Branch:

PIN:

Verify PIN:

Guarantor Name (for Children under 16):

Ethnicity:

Category 7:

Category 8:

Category 9:

Category 10:

Category 11:

Category 12:

Please choose one method to receive library notices for holds and overdue notifications:

Email
Phone
SMS Text Message

Label:

Mobile Phone Number: *

Country Code: *

Bill Notices
Overdue Notices
Hold Pickup Notices
Manual Message
General Announcements

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