IDEA Application

Application for an IDEA library card

For Idahoans who live outside of a public library service area
Name of adult household member completing this form *

First NameMiddle NameLast Name
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (complete only if different from physical address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Complete this section for each household member needing an IDEA library card
1st household member requesting a card*

First NameMiddle NameLast Name
Type of e-books for 1st household member
(choice made by parent/guardian may limit titles)
Kid Titles Kid & Teen titles Kid, Teen & Adult titles*
2nd household member requesting a card

First NameMiddle NameLast Name
Type of e-books for 2nd household member
(choice made by parent/guardian may limit titles)
Kid Titles Kid & Teen titles Kid, Teen & Adult titles
3rd household member requesting a card

First NameMiddle NameLast Name
Type of e-books for 3rd household member
(choice made by parent/guardian may limit titles)
Kid Titles Kid & Teen titles Kid, Teen & Adult titles
4th household member requesting a card

First NameMiddle NameLast Name
Type of e-books for 4th household member
(choice made by parent/guardian may limit titles)
Kid Titles Kid & Teen titles Kid, Teen & Adult titles
5th household member requesting a card

First NameMiddle NameLast Name
Type of e-books for 5th household member
(choice made by parent/guardian may limit titles)
Kid Titles Kid & Teen titles Kid, Teen & Adult titles
6th household member requesting a card

First NameMiddle NameLast Name
Type of e-books for 6th household member
(choice made by parent/guardian may limit titles)
Kid Titles Kid & Teen titles Kid, Teen & Adult titles
My nearest public library is in which Idaho city
The Idaho school district in which I reside is
I affirm that I reside in Idaho or a member of my household attends or works at an Idaho school. I understand that parents or guardians of minors assume responsibility for content of borrowed resources *
By typing your name in the box above you are electronically signing this document and certifying that all the information provided on this report is true and accurate to the best of your knowledge.
Questions about this application for access to the IDEA collection can be found at IDEA or by contacting Marina.Rose@libraries.idaho.gov Phone: (208) 639-4165.
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Application for an IDEA library card

Complete this section for each household member needing an IDEA library card