School Outreach Library Card Application

School Outreach Library Card Application
Child's Name*

First NameLast Name
Parent/Guardian Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child's Date of Birth*

MonthDayYear
Phone Number*
Parent/Guardian E-mail*
School
Teacher
I assume complete responsibility for materials charged out to my card and fines incurred by late returns. I will notify the library immediately of any change of address or phone number.

I accept these terms.
If you do not click "I Accept These Terms," your request will not be processed. Please call Lending Services 203-797-4505 ext 7731 or e-mail tcarvalho@danburylibrary.org if you have any questions.
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