W. M. LOGAN LIBRARY
SCHREINER UNIVERSITY		       

Community Patron Application Form

PLEASE PRINT

I.D. Number: (i.e., TX DL#) ___________________________________  D.O.B: _________________

Name: (Mr./Mrs./Ms.) _________________________________________________________________

P.O. Box/Street: _______________________________________________________________________

City: ___________________________________________  Zip Code: ____________________________

Home Phone: ______________________________  Work Phone: _______________________________


I have read and received a complete copy of the W. M. Logan Library’s Borrowers Policy. 

I am aware that replacement costs of $60.00 per book will be charged for books not returned that are four weeks overdue and for books not returned by the stated deadline when recalled for Schreiner University faculty or students. ___________________________________________

For Underage Patrons: A parent or guardian must assume responsibility for the materials you will be checking out by signing below.  Additionally, they must be a patron of Logan Library.  If they are not, the responsible party must also fill out an appropriate application form.

Name of the school you currently attend: __________________________________________________

Signature of person accepting responsibility for the above person: ______________________________

Printed name of responsible party: ________________________________________________________

I am already a Schreiner University patron:    YES / NO    (circle one)

Responsible party’s Patron I.D. # _________________________________________________________


For Staff Use:   Verification Source (TX DL)   _________________    Staff initials _______________

Data Entered [Library System]    _______________      Staff initials _______________