Library Card Application - High Point Christian School

Student Last Name *

Student First Name *

Middle Initial *

Grade *

Gender *

Male Female

I need to add another student *

Yes No

Student #2 Last Name

Student #2 First Name

Student #2 Middle Initial

Student #2 Grade

Student #2 Gender

Male Female

Mailing Address (Street, City, and Zip) *

Parent #1 Email Address *

Parent #2 Email Address

Parent Cell Phone #1

Parent Cell Phone #2

I agree to be responsible for material drawn on the library card issued in the above name, including material drawn on it by others with or without my consent unless I have previously reported the loss of my card. I promise to comply with all library rules and policies, and give prompt notice of change of address or loss of library card.

I understand and agree with the library rules and policy above. * (1 required)

I agree