MEMBERSHIP RECORD (, ) Card Number: Postal Address: , Home Address: , Phone (Home): Phone (Daytime): Fax: E-mail: Textmessaging: Membership Number: Membership: Area: Fee:$30/year, Paid Joined: , Expires: Joining Branch: Ethnicity: , DoB: Sex: Alternative Contact: Phone: Relationship: Notes: Guarantees: Guarantor: no guarantor General Notes: FINES & CHARGES ITEMS CURRENTLY ON ISSUE Title Due Itemtype Charge Renew On Request - no renewals Y N ITEMS REQUESTED Title Requested Remove No Yes
