/images/background-mem.gif">MEMBERSHIP RECORD

/images/add-child.gif">


(, )

Card Number:
Postal Address: ,
Home Address: ,
Phone (Home):
Phone (Daytime):
Fax:
E-mail: ">
Text messaging:

Membership Number:
Membership:
Area:
Fee:$30/year, Paid
Joined: , Expires:
Joining Branch:

Ethnicity: ,
DoB:
Sex:

Alternative Contact:
Phone:
Relationship:
Notes:

Guarantees:">
 Guarantor: ">
no guarantor

General Notes:

"> /images/modify-mem.gif"> /images/delete-mem.gif">

">Password

">Privileges
/images/holder.gif" width=16 height=800 align=left>
/images/background-mem.gif" colspan=4>FINES & CHARGES
&bib=&bi=">  
>/images/view-account.gif"> >/images/pay-fines.gif">

">
/images/background-mem.gif" colspan=6>ITEMS CURRENTLY ON ISSUE
/images/background-mem.gif">Title /images/background-mem.gif">Due /images/background-mem.gif">Itemtype /images/background-mem.gif">Charge /images/background-mem.gif">Renew
&bib=&bi="> ">On Request - no renewals " value=y>Y " value=n>N
/images/update-renewals.gif">

"> ">
/images/background-mem.gif" colspan=5>ITEMS REQUESTED
/images/background-mem.gif">Title /images/background-mem.gif">Requested /images/background-mem.gif">Remove
">
/images/cancel-requests.gif">


">/images/reading-record.gif">