Online Form - Bindoon Library Membership Application

Full Name*

Please provide a valid Postal Address

Street Address:*

City:*

State:*

Post Code:*

Country:*

Phone number*

Email Address*

Date of Birth*

Identification: Please provide either your Driver's License/Passport number or Pensioner Concession Card number*

I agree to the following conditions:*

I agree to comply with the Library Code of Conduct as found on the web page
I agree that the information I have provided is true and correct
I agree to notify the Library if my card is lost or stolen
I agree to return items borrowed in the condition that I received them

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