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    Ethekwini Municipal Library: Re-Reg

    Uploaded by

    Rosmary Swartbooi

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Ethekwini Municipal Library: Re-Reg

    Uploaded by

    Rosmary Swartbooi
    141 views3 pages

    Original Title

    MembershipEng0709.pdf

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    141 views3 pages

    Ethekwini Municipal Library: Re-Reg

    Uploaded by

    Rosmary Swartbooi

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Re-reg

    New
    Membership No: ________________ A P V J JA

    ETHEKWINI MUNICIPAL LIBRARY


    APPLICATION FOR ADULT MEMBERSHIP (18 YEARS OR OLDER)
    and/or PARENT/GUARDIAN DETAILS
    FOR JUNIOR MEMBERSHIP
    ETHEKWINI
    M U N I C I P A L
    L I B R A R Y

    Please produce 1) Your original identity document/passport and a photocopy for our records
    2) Proof of your current address

    PERSONAL INFORMATION
    Surname : Mr/Mrs/Ms
    (Please print)
    First Name/s :
    (In full)
    Postal Address : Identity Number :

    WORK INFORMATION
    Name of Business/Company
    Code:
    Name of Business :
    Home Address :
    Work Address :

    Code:

    Home Tel No : Code:

    Cell Phone No : Work Tel No :

    e-mail Address : e-mail Address :

    ALTERNATIVE ADDRESS ADDRESS OF WHERE NOTICE CAN BE SERVED IN


    CASE OF LEGAL ACTION:
    Name of relative, friend or neighbour not at the same address
    Name : (Please tick box)

    Address : Home : Business Postal

    Code:
    Tel No :

    As a ratepayer / resident / employee / student within the eThekwini Municipality, I hereby apply for membership
    of the library. I agree to observe the by-laws, rules and regulations of the library and the Kwa Zulu-Natal
    Provincial Library Service. I undertake to be responsible for any items borrowed on my membership card and / or
    my children’s membership card/s, by myself or any other person, and to pay the relevant fines, replacement
    costs and expenses incurred by the library in recovering such items or payments. I hereby agree to abide by all
    legal requirements as laid down in the Copyright Act, 1978 (Act No. 98 of 1978) as amended. I also agree to give
    immediate notice of any change of address, telephone number or any of the details above.

    Applicant’s Signature : ________________________ Date:____________________

    Jan 2007
    APPLICATION FOR JUNIOR MEMBERSHIP ( 0-17 YEARS )
    Please produce each child’s original barcoded identity document or birth certificate and a ETHEKWINI
    photocopy for our records. M U N I C I P A L
    L I B R A R Y

    Membership No : Membership Type: J JA

    Surname : First Name/s :


    (In full)
    (Please print)
    Identity Number : Date of birth :

    Name of school : School Tel No :

    This child, being 12 years or older, is permitted to borrow any adult book/s: Yes No

    Date: Signature of parent/guardian :

    Membership No : Membership Type: J JA

    Surname : First Name/s :


    (In full)
    (Please print)
    Identity Number : Date of birth :

    Name of school : School Tel No :

    This child, being 12 years or older, is permitted to borrow any adult book/s: Yes No

    Date: Signature of parent/guardian :

    Membership No : Membership Type: J JA

    Surname : First Name/s :


    (In full)
    (Please print)
    Identity Number : Date of birth :

    Name of school : School Tel No :

    This child, being 12 years or older, is permitted to borrow any adult book/s: Yes No

    Date: Signature of parent/guardian :

    FOR OFFICE USE ONLY


    Branch/Depot :
    Registration Date :(Y) (M) (D)
    Membership Type:
    Expiry Date :(Y) (M) (D)
    Checked by : Service No:
    Librarian’s : Service No:
    Signature
    Reference verified: Yes No Captured by:

    Ref. No-310501:GB
    yes

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