Date:___________

Name (Last):___________________ Name (First):_______________________________

Name (Middle Initial):___________________

Library Barcode Number: _______________________

Department and Campus Box Number: ____________________

Phone (Campus):______________ (Home): ______________ Email: _______________


Mailing Address:

_______________________________________________________________________________

Status:

• Faculty
  
• Staff
  
• Graduate
• Undergraduate
• Senior Thesis

To the Applicant:

• You will need to register at each Boston Library Consortium (BLC) library from which you wish to borrow materials. The lending library may set a shorter expiration date than the one appearing on your card.
  
  
• Borrowing privileges and expiration dates vary at each member institution. Please note that there are different loan periods and fine structures at each library. You are responsible for any charges you accrue. Failure to abide by lending library rules may result in loss of library privileges at all Consortium libraries, including Brown University. Fines and bills accrued may be billed to your Brown account. Please see the BLC User Guide for information on individual institution's fees.
  
  
• Consortium cards are non-transferable.

Expiration Date:   January          May          August

This page was last updated on