Library Registration Form

First Name

Middle Initial

Last Name

Credentials

Department

Supervisor

Employee Number

If you do not have an employee number use the barcode number from the back of your badge. Your library ID number will be su + your employee (or barcode) number.

Pager (if applicable)

Phone

Is this your work or cell phone number?

Work

Cell

Will only be used for Library business – does NOT have to be a Summa email address.

I understand that books circulate for three weeks, and it is my responsibility to renew or return books on time. I understand that I am responsible for all items checked out in my name. This includes damaged or lost items and overdue fines.

I accept my responsibility for library materials that I borrow as described above.

Date

Library Registration Form

I understand that books circulate for three weeks, and it is my responsibility to renew or return books on time. I understand that I am responsible for all items checked out in my name. This includes damaged or lost items and overdue fines.

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