MEMBERSHIP RECORD
(, )

Card number:
Postal Address: ,
Home Address: ,
Phone home:
Phone daytime:
Fax:
E-mail: ">
Text messaging:
Membership Number:
Membership Category:
Fee: $30/year, Paid
Joined: , Expires:
Joining branch:

Ethnicity: ,
DoB:
Sex:
Alternative Contact:
Phone:
Relationship:
Notes:

Guarantees:
"> -
Guarantor: ">
No guarantor

General Notes:


">
">
">
FINES & CHARGES
Total due No debts

"> View Account "> Pay Fines

ITEMS CURRENTLY ON ISSUE
">
Title Due Itemtype Charge Renew
&bib=&bi="> ">On Request - no renewals " value="y">Y " value="n">N
None
ITEMS REQUESTED
Title Requested Remove
"> "> ">
None

">Reading Record