If you are 14 years of age or older use the following form. You may move from one box to the other by using the tab key or by clicking in the desired box with your mouse. All boxes marked with an* must be filled in.   Review our Privacy Policy   * First Name: Middle Name: * Last Name: Preferred Name: Birth Date (dd/mm/year): Female Male * Mailing Address: (Example: RR #2 or P.O. Box 123, etc.) * Civic Address * City Province - Nova Scotia Only * Postal Code: * Telephone number where you prefer to be contacted: (ex. 555-5555) (902) Other Number(s) - if desired: (ex. 555-5555) (902)    Note (work, etc.) (902)    Note (work, etc.) E-mail Address (optional): NOTE: by providing an e-mail address, you are granting permission for your personal library information to be communicated to this address. (Example: notices about loaned material). * Municipal area of residence, please choose one: Annapolis County Kings County District of West Hants Town of Annapolis Royal Town of Berwick Town of Bridgetown Town of Hantsport Town of Kentville Town of Middleton Town of Windsor Town of Wolfville Other If you are a seasonal resident, please provide your other mailing address (for mail out notices, etc.): Civic/Mailing Address: (Example: 123 North Street, RR 2) City Province Postal Code: * The location where you would prefer to pick up material, please choose one: Annapolis Royal Berwick Bridgetown Hantsport Kentville Kingston Lawrencetown Middleton Outreach Services Port Williams Windsor Wolfville * I, (please enter full name), agree to take responsibility for the materials borrowed on this card and to abide by the rules and regulations of the Regional Library. Back To Top About the Library  Contact Us  Branches/Outreach  Text Version ---------------------------------------------------------   © Annapolis Valley Regional Library Site Development by Paradise Consulting Services Site Graphics by Todd Graphic Last updated: 17/05/2013