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Juvenile Library Card

Child Information

Last Name

First Name

Middle Initial

Address

City

State

Zip Code

Phone

Email

Birth Year

Have you had a previous library card in Westchester?
YesNo

Select your preferred method of contact:
PhoneEmail

Parent Information

I agree to be responsible for all library materials borrowed on my child's card, to pay any fine charged to my child's card for overdue, damaged, or lost materials, and to notify this library if our address changes or my child's card is lost or stolen.

Last Name

First Name

Middle Initial

Address

City

State

Zip Code

Phone

Email

Select your preferred method of contact:
PhoneEmail

Would you like to receive emails from us alerting you of upcoming events?
YesNo

This information will NOT be shared with other parties and is solely for notification purposes.

Do you want charge history kept?
YesNo

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