Application for Retired Staff Borrowing
ABN 63 942 912 684
 
Fill out sections required, print and sign the form. 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 *
Phone No. * (At least one) Home     Mobile  
Retired UQ Staff Position
  Years of service
  Staff number
   I agree to abide by the Library Code of Practice as stated on the Library's website.
   I have read the membership guide for the general public and I am aware that membership does not include remote access to electronic resources.
Signature _________________________ Date _________________
 
OR
Hand the form in at:
any Branch Library
or
Fax: (07) 3365 6888 		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 Memberships & Payments Desk at the Social Sciences & Humanities Library. Please note that photo ID and proof of address must be presented at time of collection.
 
Library use only
Date received 
Expiry date 
Barcode24067
Patron type 
Stat class