Johnston Public Library Card Application

You must provide a picture I.D. and current proof of address upon picking up your card. Any form of mail is acceptable with applicants name; utility bill, bank statement, etc. - Please allow up to 24 hours for processing. - Out of state residents must pay $25 yearly for library privileges. - Application must be filled out by a legal adult living at the residence. - Limit of 2 items at first checkout. - Replacement fee for first lost card: $2.00. Every additional replacement card: $10.00. - Patrons may not use a temporary case worker/job hunter as contact number. - IF YOU HAVE ANY QUESTIONS REGARDING THIS APPLICATION PLEASE CONTACT US AT (620) 856-5591.

Name(Required)

First Last

Address(Required)

Physical Address Only - No P.O. Boxes

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Work Phone Number

If Renting, Landlord's Name(Required)

If not applicable, please put N/A.

If Renting, Landlord's Phone Number

Email Address(Required)

Please list all household members who may use your card:

How would you prefer to be contacted?(Required)

Text

IF you selected text, please provide your cell phone carrier.

Examples: Sprint, ATT, Straight Talk, etc.

Emergency Contact Name(Required)

Contact must not live in same household.

First Last

Emergency Contact Phone Number(Required)

Emergency Contact Address(Required)

Street Address Address Line 2 City State ZIP Code

Consent(Required)

Please read the following and make a selection below:

I apply for the right use the library and promise to obey all rules, to take good care of all library materials I borrow, to pay all fines or damages charged to me, and to give prompt notice of change in my address and/or phone number. I understand that if I do not comply with the above requirements I will lose my library privileges.

I understand and agree.

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Johnston Public Library

210 West 10th
Baxter Springs, KS 66713

► Library Hours

Mon: 9:00 - 6:00
Tue - Fri: 9:00 - 5:00
Sat: 9:00 - 12:00

► Phone

(620) 856-5591

Johnston Public Library Card Application

Johnston Public Library

► Library Hours

► Phone

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