W. M. Logan Library Please Print Clearly Name: (Mr. /Mrs. /Ms.) ___________________________________________________ County: ______________________________________ Zip Code: _______________
Signature: _____________________________________________ Date: _____________ For Underage Patrons Name (please print): _______________________________________ D.O.B: ______________ Name of the school currently attended: ______________________________________________ A parent or guardian must accompany an underage person who wishes to complete a Logan Library community patron application form. The parent or guardian must sign below to signify that they are aware they are assuming financial responsibility for all of the materials to be checked out. Additionally, the parent or guardian must already be a patron of Logan Library or must complete an application form to accompany the underage person’s form. Signature of responsible party: __________________________________________________ Printed name of responsible party: ________________________________________________ Patron ID of responsible party: _______________________ For Library Use Only Address verified by a Photo ID & a Texas Drivers License – Library Staff Initials _________ |