Library Borrower Information Sheet

Library Borrower Information Form for WPCC Students, Faculty, Staff and Community

Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone
College ID Number:
Signature
By typing my full name, I understand that I am responsible for any materials checked out in my name, and that I may incur charges for overdue, damaged, or lost library materials.
Date of Submission:
MM slash DD slash YYYY
I am a...
- WPCC Student
- WPCC Faculty/Staff
- Community User