ERADL Library Card Renewal

ERADL Card Renewal

This application is only open to individuals who are 18 years of age or older and reside within our designated service area. If you live outside of the Eaton Rapids Township, Hamlin Township, or the City of Eaton Rapids, please be aware that you will receive an email notification regarding the applicable annual fee. Individual Registration: $25 annual fee. Family Registration: $45 annual fee.
Name*

First NameMiddle NameLast Name
Library Card Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth*

MonthDayYear
E-mail*
example@example.com
Phone Number*
Preferred Contact Method:*
Drivers License Number*
Monthly Newsletter Registration
Signature*

Powered by Jotform SignClear
By submitting this application, I declare that all information provided is accurate and I agree to the Eaton Rapids Area District Library Policies, specifically the Circulation Policy. I acceept responsibility for all use of the card, all library materials checked out with the card, and all charges made against it. I understand that use of my library card is non-transferable and in the event either the wallet size or keychain card is lost or stolen, I will notify ERADL immediately. I understand that the Library's use of personal information is governed by its Privacy Policy.
Name and Address Verification (This can be a State Issued ID, Driver's License, or formal piece of mailing (example: utility bill))*

This can be a State Issued ID, Driver's License, or formal piece of mailing (example: utility bill)
Cancelof
Signing Date*

MonthDayYear
Should be Empty:

ERADL Card Renewal