Jones Library Card Application

2. Ver este formulario en español

   PLEASE NOTE: This online application is for Amherst residents only.

   Please fill out this form and a library staff member will complete your registration and email you when your library card is ready to pick up. Please be prepared to show us a photo ID and proof of your Amherst address.

4. Home library*
   -- Select One --Jones Library
6. NOTE: Please enter your responses in ALL CAPITAL LETTERS
8. First name*
10. Middle name
12. Last name*
14. Preferred first name
    (if different)
16. Preferred last name
    (if different)
18. Date of birth*
    Date of birth
    mm/dd/yyyy
20. Are you currently a college student?*

    1. Yes
    2. No
22. Email address*
24. Phone number*
    please include dashes | example: 413-259-1234
26. Mailing address*
28. Apartment number
30. City*
    -- Select One --Amherst
32. State*
    -- Select One --Massachusetts
34. Zip code*
    example: 01002
36. Is this a PO Box address?

    1. Yes
    2. No
38. Please also provide a street address. Thanks!
    
    Street address*
40. Apartment number
42. City*
    -- Select One --Amherst
44. State*
    -- Select One --Massachusetts
46. Zip code*
    example: 01002
Leave This Blank:


48. Submit

* indicates a required field