Application for Library Membership
Temporary Visitors (Not on a University system)
ABN 63 942 912 684
Fill out sections required, print and sign the form.
This section and the Computer and Internet Use Agreement are 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.
   I have read the membership guide for the general public and I am aware that membership does not include access to electronic resources.
Signature _________________________ Date _________________
 
Library use only
Date received 
Expiry date 
Barcode24067
Patron type 
Stat class 
Computer and Internet Access Agreement
To be completed, printed and signed by the applicant.
 
1. I agree to abide by the conditions set out in the Computer and Internet Access and Conditions of Use
2. I understand that the Telecommunications Act 1997 and the Broadcasting Services (Online Services) Act 1999 prohibit the University from providing unsupervised access to the Internet to anyone under the age of 18 without evidence of consent by their parent or legal guardian.
  I am over 18 years of age
Or  
  I am providing written permission from my parent/guardian with this application
[If you are under 18, please have your parent/guardian sign the online permission form]
[Library staff: If the Applicant is under 18, please copy the "Internet Access Permission for Under 18s" form and attach the copy to this application. Forward the original to ITS Service Centre, Staff House Road, St Lucia Campus.]
 
Name of Applicant:
Signature of Applicant: ..........................................................................
Date: