Library Card Application*

Single Checkbox Field

Is This a Renewal?

If it is a renewal, do you need a replacement card?

Enter your 14 Digit Barcode # (if you know it).

Enter your EWML Account Username (if you know it).

If this is for a new card, would you like a keychain card along with your large card?

Have you ever had a library card from Monroe or another Connecticut library?

If yes, what town?

First Name

Middle Initial

Last Name

Year of Birth

Email

Would you like Email Receipts instead of Paper?

Single Checkbox Field

I understand that I am responsible for notifying the library immediately if I lose my card.

Primary Phone

Secondary Phone

Other Phone

I would like to receive notifications by:

For text notifications, please provide a cell phone number:

Select your carrier:

If you selected other, please specify your carrier.

Zip Code

Street Address (1)

Street Address (2)

City

State

Allow others to use my account:

If yes, please list the names of the users:

These users are allowed to:

Would you like a voter registration form along with your new library card?

Which library program notification emails would you like to receive?

Would you like your card to be connected to other members of your family?