Woodland Public Library Library Card Application To apply for your library card, Please print out this form and then fill it out. Then sign it and bring it in to the library along with a valid ID. First name:   Last Name:   Home Address:   City:   ZIP:   Mail Address (if different):   Mail City:   Mail ZIP:   Home Phone:    Work Phone:   Birthday (to distinguish between people with same name) Month:   January February March April May June July August September October November December   Day:   Reference Name (someone NOT in your household):     Phone:   Reference Address:   ________________________ Signature of Applicant   ________________________ Signature of Parent or Guardian Required if Applican is under 14 years of age You can help plan for the future of the library by providing the following information. It is voluntary and the information will be used only by the library for planning library services. Check the spaces which apply. Ethnic Background Age White American Indian Hispanic Asian/Pacific Islander Black Other:  Under 14 14 to 54 55 and over

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