Library membership application Library membership application First name Middle name Surname Date of birth Gender - None -MaleFemaleNot specified Phone Email Re-enter email address Residential Address (must be within NT) Address Suburb/town State State Northern Territory Postcode Postal Address - Select -Same as residential addressDifferent postal address Postal address Address Suburb/town State Northern Territory Postcode Would you like to join your dependent children under 18 years old while you are here? - Select -YesNo Dependants Re-order Dependant Date of Birth Gender Weight Operations Dependant Date of Birth Gender - None -MaleFemaleNot specified Item weight Add more items more items type Type of Library Membership Online access membership (I only intend to access the online resources) Full membership (you will need to upload proof of your current address and photo ID) card_coll Nearest branch - Select -CasuarinaDarwin CityKaramaNightcliff Photo ID A current NT Driver’s Licence OR Defence Force ID, Student Card, Interstate Driver’s Licence, Royal Darwin Hospital ID Card, Passport, 18+ Card.One file only.3 MB limit.Allowed types: gif, jpg, jpeg, png, pdf, doc. Proof of permanent NT residential address (if not listed on your photo ID) Health Care Card, Pension Card, Enrolment to Vote Card, Lease Agreement, Phone/Power and Water/Credit Card Bill, Bank Statement, Any official /business letter showing name and permanent NT address.One file only.3 MB limit.Allowed types: gif, jpg, jpeg, png, pdf, doc, docx. Conditions of membership Conditions of membership Please ensure you have read and understood theCity of Darwin Privacy Statement,City of Darwin Libraries Membership Guidelines andCity of Darwin Libraries Code of Conduct before submitting your request. ackn Acknowledgement I acknowledge that I have read and understood the City of Darwin Privacy Statement, City of Darwin Libraries Code of Conduct and City of Darwin Libraries Permanent Membership Guidelines. agree_fieldset Agreement I agree to Agree respect the rights and security of staff and other library users accept responsibility for all items borrowed on my card and to pay for replacement costs and processing fees for any items lost, stolen, or damaged abide by City of Darwin Libraries Membership Guidelines and City of Darwin Libraries Code of Conduct.