Fill out the form and PRINT. Present this at any library branch along with identification with your name and current address. All residents of and/or real property owners in the City of Charlottesville, and the counties of Albemarle, Greene, Louisa and Nelson are eligible to obtain free library cards. All others will have a $30 annual fee.
|Mailing Address (include Apt. #)|
||Zip Code |
|Telephone (include area code)
||City or County of Residence
|Your residential or permanent address if different from above (Number, Street, Apt #)|
|E-mail address (Optional. Holds notices, overdue notices and courtesy notices will be sent by e-mail. Please print clearly)|
For Parent or Guardian of Minor Applicant (Under 16)
I acknowledge that this library card entitles my child to complete access to all library materials. I assume responsibility for library materials borrowed by this child from the library.
Signature of Parent