Application for Alumni Friends of UQ Membership
ABN 63 942 912 684
 
Fields marked * are compulsory  
Title (Mr,Mrs,Ms,Dr,etc.)
Last Name *
First Name and other initials *

Date of Birth *
As required by the Broadcasting Services Act

Home Address *

Email Address *

Previous UQ Student Number

UQ Awards (eg. BSc, DipEd, MA) and year(s)

Phone No. *  
Home and/or
Work and/or
Mobile
I am a current member of Alumni Friends of the University of Queensland
I agree to abide by the Library Conditions of Use
I have read the borrowing guide for Community members and understand my entitlements and responsibilities
 
Signature _________________________ Date _________________
 
Please hand the form in at:

  any branch library 		or Send to: Circulation
Information Access Service
Duhig Building
The University of Queensland Library
St Lucia 4072
You will be advised by email when your library card is available for pickup from the Loans Desk at the Social Sciences & Humanities Library. Please note that proof of Alumni friends membership must be presented at the time of collection.
 
Fee 1 year $140.00 (GST incl.) or 6 months $90.00 (GST incl.)
Payment method Fee must accompany application
  Cheque AUD$ Bank Draft
Payable to: The University of Queensland Library
Eftpos Visa
Mastercard    
 
Cardholder Name
Cardholder Number
Expiry date