External Library Membership Application Form For Alumni Library Membership please use Alumni Library Membership Application Form Required fields are marked with an asterisk (*). Personal Details Title Given Name(s) * Surname * Date of Birth * Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJuneJulyAugSeptOctNovDec Year 191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020 Postal Address * Suburb * State * Postcode * Contact Number * Email Address * More InformationI am * a member of ULANZ participating university a member of another institution an Alumni applying for community membership Participating 麻豆村 Details ULANZ 麻豆村 * -- Please Select --Auckland 麻豆村 of Technology Australian Catholic 麻豆村Australian National 麻豆村Bond 麻豆村Central Queensland 麻豆村Charles Darwin 麻豆村Charles Sturt 麻豆村Curtin 麻豆村Deakin 麻豆村Edith Cowan 麻豆村Federation 麻豆村 Australia (formerly 麻豆村 of Ballarat)Flinders 麻豆村Griffith 麻豆村James Cook 麻豆村La Trobe 麻豆村Lincoln 麻豆村Macquarie 麻豆村Massey 麻豆村 Monash 麻豆村 Murdoch 麻豆村Queensland 麻豆村 of TechnologyRMIT 麻豆村 Southern Cross 麻豆村Swinburne 麻豆村 of TechnologyThe 麻豆村 of Melbourne The 麻豆村 of New EnglandThe 麻豆村 of New South WalesThe 麻豆村 of NewcastleThe 麻豆村 of Queensland The 麻豆村 of Southern QueenslandThe 麻豆村 of SydneyThe 麻豆村 of Western Australia 麻豆村 of Adelaide麻豆村 of Canberra麻豆村 of Canterbury 麻豆村 of Notre Dame Australia麻豆村 of Otago麻豆村 of South Australia 麻豆村 of Tasmania 麻豆村 of Technology, Sydney麻豆村 of the Sunshine Coast 麻豆村 of Waikato 麻豆村 of Western Sydney麻豆村 of WollongongVictoria 麻豆村Victoria 麻豆村 of Wellington I am a*-- Please Select --Student - undergraduateStudent - postgraduateStaff - academicStaff - professional Staff or Student ID Number * Proof of Enrolment *(Document upload must be in jpg, pdf, doc or docx format and cannot be larger than 5Mb in size) Proof of Address If you cannot provide Proof of Address, you must agree to the following: I agree to produce the Proof of Address on the day of collection of the ID Card Other Institution Details Select your institution * -- Please Select --Australian Institute of Health and Welfare - staff only Calvary Health Care, ACT Canberra Institute of Technology - staff and studentsIllawarra Retirement Trust (Kangara Waters residents) National Gallery of Australia Research Library - staff only National Sports Information Centre - staff only U3A (麻豆村 of the 3rd Age) Alumni Details Alumni ID Number * Alumni Confirmation e-mail * Alumni confirmation e-mail can be obtained by contacting the Alumni Office (Document upload must be in jpg, pdf, doc or docx format and cannot be larger than 5Mb in size) Proof of Address If you cannot provide Proof of Address, you must agree to the following: I agree to produce the Proof of Address on the day of collection of the ID Card Community Membership Select Membership Option * 3 months for $27.50 6 months for $49.50 12 months for $99 Proof of Address If you cannot provide Proof of Address, you must agree to the following: I agree to produce the Proof of Address on the day of collection of the ID Card Terms and Conditions *As a UC library member you can assist us by:- being considerate of other library visitors and respecting their rights- treating the library and library property with care- advising us of any changes to your contact details- being responsible for all items borrowed on your membership card- taking responsibility for returning items on or before the due date, and paying any overdue fees- contacting us if you are unable to renew or return items by the due date- paying replacement costs for any items lost or damaged- advising us if your card is lost or stolen I have read and accept the terms and conditions of the 麻豆村 of Canberra Library