Application for Graduate 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 agree to abide by the Library Conditions of Use.
I have read the membership guide for UQ graduates, including the list of available databases, and I am aware of my entitlements.
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 photo ID and proof of address must be presented at time of collection.

Fee 1 year $150.00 (GST incl.)
Payment method  (fee must accompany application)   Payment amount:  
  Cheque AUD$ Bank Draft
Payable to: The University of Queensland Library
Eftpos Visa
Mastercard    
Cardholder Name

Cardholder Number

Expiry date