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My Yorkshire
Helps communities to become digital storytellers, combining storytelling with multimedia.
Reading for life
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Home: Community full menu: Libraries

Apply to join Kirklees libraries

Kathryn Harrison - December 2010
frontline.services@kirklees.gov.uk

To apply for membership of Kirklees libraries, complete this form. Please fill in all parts of this form which are marked with a *

Your details

Title
First name	*
Last name	*
Day of birth
Month of birth
Year of birth	*
House number and street name
Area
Town
Postcode

For students who do not normally live in Kirklees

Student: house number and street name
Student: Area
Student: Town
Student: Postcode

College

College
Course

Contact details

Telephone area code
Telephone number
Email address
Mobile phone number

Disability information

Do you consider yourself to be a disabled person?

Yes
No

What your disability affect?

Hearing
Mobility
Vision
Other

Which ethnic group do you consider yourself to belong to?

White
Black Caribean
Black African
Black Other
Pakistani
Bangladeshi
Chinese
Asian Other
Other

Choose the library you want to collect your card from

Choose a library from the list*
Note: When you collect your library card you will need to sign it. You will need to bring with you proof of your name, address and signature, for example: Your driving license or a utility bill and a credit card If you are under 16 your parent or guardian must sign for you. They will be held responsible for any items you borrow.

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