EmailMe Form - Library Card Application

Cardholder Information

I am a member of *

Buffalo Lake Métis Settlement

Elizabeth Métis Settlement

Fishing Lake Métis Settlement

Frog Lake First Nations

Goodfish Lake First Nation

Heart Lake First Nation

Kehewin Cree Nation

Kikino Métis Settlement

Onion Lake Cree Nation (Alberta)

Saddle Lake Cree Nation

Other Style of Address

Name of Cardholder *

First Last

Middle Name or Initial (if applicable)

Cardholder's Date of Birth *

MM / DD / YYYY

Cardholder is... *

Female

Male

Name of Legal Guardian if Cardholder is under 18 years of age.

The Guardian assumes responsibility for any potential unpaid fines or damages incurred by the Cardholder. A letter will be sent to the Guardian named, to let them know their name appears on this form.

First Last

Do NOT fill in this field without the express permission of your Guardian.

Primary eMail

We strongly suggest you provide an email address, as this is the best way for the library to notify you of holds ready for pickup and of due dates for borrowed materials.

Daytime Telephone Number *

### - ### - ####

This is a... *

Mobile (cellular) phone

Office phone

Home phone

Other

Mailing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Your library card will be mailed to this address via Canada Post.

Maintain Reading List

If you wish, NLLS will keep a list of all materials you borrow through the TRAC system. This information is for your own personal use, and will not be used by NLLS.

Please maintain my reading list

Notification Preferences

System notifications (hold alerts, due dates) will be automatically set up to be sent to your primary eMail address. If you have not provided an eMail address, your notifications will be sent by letter.

If desired, please indicate if you would like to receive additional notifications using:

Text Message, at mobile phone number provided above (standard text message rates apply, please name your cellular carrier in field below)

Text Message Carrier (e.g. Telus, Bell, Virgin)

If you do not regularly check your eMail, you may wish to change your primary notification method to one of the following:

Text message, at mobile phone number provided above (standard text message rates apply, please name your cellular carrier in field above)

Call daytime phone number

Letter (Canada Post)

Terms and Agreements

Please read and check all the following statements to ensure your form is processed. *

1) Card must be present each time materials are borrowed.

2) Loss of card or change of address must be reported.

3) Privileges extended with card may be revoked for cause.

4) Card is not transferable.

5) I agree to be responsible for all materials borrowed on my card, and to abide by the rules and regulations of the library where I use my card.

The personal information collected on this application is used to provide you with library services at participating members of TRAC and the Alberta Library. It may be shared with these libraries to verify membership and to collect fines or debts owing, and to provide information about library services, and for statistical purposes. It is collected under the authority of Section 32C of the Freedom of Information and Protection of Privacy Act, and is protected under this act. If you have any questions on disclosure or use of this information, please ask your librarian.

For more information about TRAC, please visit www.tracpac.ab.ca *

I have read this.

By checking this box, I verify that all the information provided by me on this form is correct and up to date.

If under the age of 18, I have secured the permission of my Legal Guardian to apply for this card. *

Virtual Signature

OFFICE USE ONLY: Library Card Number