Member# , Card Number*
MEMBER PERSONAL DETAILS			* checked>F checked>     Date of Birth (dd/mm/yy)
No Title >
Title	Initials	Given Names*	Surname*	Prefered Name
>
Ethnicity		Ethnicity Notes						Membership Category*
MEMBER ADDRESS
				> -
Postal Address*			Town*	Area
Street Address if different			Town
MEMBER CONTACT DETAILS
Phone (Home)		Phone (day)	Fax	Email
ALTERNATE CONTACT DETAILS
				>
Name*			Phone	Relationship*
Notes	<TMPL_VAR NAME=altnotes>
LIBRARY USE
Notes	<TMPL_VAR NAME=borrowernotes>
FLAGS
		>Yes >No