Library Card Application

Your Full Name (Required)

Name of State Agency or Business or School (Required)

Address of State Agency or Business or School (Required)

City of State Agency or Business or School (Required)

State of State Agency or Business or School (Required)

Zip Code of State Agency or Business or School (Required)

Telephone Number of State Agency or Business or School

Provide a number where you can be reached at work or school

E-mail Address at State agency or Business or School

Provide an e-mail address where we can contact you

Home Street Address (Required)

Home City (Required)

Home Zip Code (Required)

Home Telephone Number (Required)

Cellular Phone Number

Home E-Mail Address

Terms of Agreement (Required)

I agree to abide by the circulation policies of the State Library of Iowa. I understand that I will be held personally responsible for the repair or replacement costs of any materials damaged, lost, stolen, or unreturned which have been borrowed in my name.

I agree
I do not agree

For security please type the characters in the box (Required)

Letters are case sensitive

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