Application for Library Membership - Staff Awaiting Creation of Aurion Record
ABN 63 942 912 684
Fill out sections required, print and sign the form.
This section is to be completed and signed by the applicant. The Letter of Introduction and Indemnity is to be completed and signed by the Head of School.
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

Departmental Address *

Home Address *
Email Address *
Phone No. * (At least one)
   Home     Work     Mobile  

Home institution *
   I agree to abide by the Library Code of Practice as stated on the Library's website.
Signature _________________________ Date _________________
 
Library use only
Date received 
Expiry date 
Barcode24067
Patron type 
Stat class 
Letter of Introduction and Indemnity
For staff awaiting creation of an Aurion record only
To be completed, printed and signed by the Head of School or their equivalent
Date
 
To the Library Manager:
Please arrange for temporary library membership for:
The School agrees to indemnify the Library for any loss or damage to Library property, or any charges incurred by the person named above.
Please indicate the appropriate category:
 
  UQ staff
  Adjunct academic staff
  Official visiting fellow / scholar
  Official visiting professor
  Academic title for externally funded health professional
  Honorary appointment
  Industry Fellow
  Conjoint appointmenmt
 
I understand that this is a temporary record only and that an Aurion record must be created. I understand that the temporary record will be valid for one month, or, for the duration of the staff member's appointment, whichever is the shorter.
Yours sincerely
 
Signature (Head of School or equivalent)

Name (Head of School or equivalent)
Please return this completed letter together with a signed Application for Library Membership form (above) to any UQ Branch Library.