ESSEX PUBLIC LIBRARY
Application for Library Card
Please fill in the form below.
Note:You may apply on-line for a library card if you live in Essex County. Under
certain circumstances we issue library cards to people who do not live in Essex
but they must apply in person at the library. On-line issued library cards are
valid but inactive until they are used.

Last Name:
First Name:
Age: 18 or older Under 18
E-Mail:
Mailing Address:
City:
State:
Zip:
 Home Phone:
 Daytime Phone: (if different)
911 Address:
Card: I will pick up Please mail it.
If under 18, please supply the following information:
Parent's Name:
Parent's Day Phone:
Date of Birth (dd/mm/yy):
When you activate this card, you will be asked for a Social Security Number.