2. • Parents/legal guardians assume all responsibility for all materials borrowed on their children's cards, and for payment of overdue, replacement or other charges.
4. • Library borrower and circulation records are confidential and exempt from Freedom of Information requests.
6. • Parents/legal guardians may check out items for their children using their children’s cards.
8. • Parent/legal guardians must present current ID and proof of Norwalk residency when picking up the card.
10. • If a parent/legal guardian is not available, a responsible adult (such as, but not limited to, an aunt, uncle, grandparent, sibling, cousin, teacher or caregiver over the age of 18) may help with the process.
12. • The responsible adult cannot sign the application. Instead, he/she can present an application signed by the child’s parent/legal guardian and a photocopy of the parent’s/legal guardian’s photo ID and proof of Norwalk residency. If the parent/legal guardian does not have a photo ID, the child's card will be limited to two items.
14. • If a child attends school in Norwalk, but resides in another town, a responsible adult may be issued a library card for the child to use only in the Norwalk Public Library System that is renewable after one year. For those who are students in town we will request a current school ID.
18. First Name*
19. Last Name*
21. Street Number*
22. Street Name*
23. Apt #
25. City*
26. State*
27. Zip*
29. Home Phone Number*
30. Cell Phone
32. Email*
34. Date of Birth*
    mm/dd/yyyy
36. Select the child's school level: *

    1. Pre-K
    2. Kindergarten
    3. Elementary
    4. Middle
    5. High
37. Select your child's school:
    -- Select One --Brookside Elementary SchoolColumbus Magnet SchoolCranbury Elementary SchoolFox Run Elementary SchoolJefferson Science Magnet SchoolKendall Elementary SchoolMarvin Elementary SchoolNaramake Elementary SchoolRowayton Elementary SchoolSilvermine Elementary SchoolTracey Elementary SchoolWolfpit Elementary SchoolSide by Side Charter SchoolAll Saints Catholic SchoolOther
39. Enter the name of your child's school:
41. Parent or Legal Guardian's Information
43. First Name*
44. Last Name*
46. Please select a pick up location.*

    1. Main Library - 1 Belden Ave., Norwalk, CT 06850
    2. SoNo Branch Library - 10 Washington St., Norwalk, CT 06854
50. Permission Statement:
    I give my son/daughter permission to borrow library materials and understand that I am responsible for all materials borrowed on the card, and will pay all late charges and fees for damaged and lost materials. I will notify the library if my child's card is lost or stolen, and of any address change.
51. I Agree with these terms:

    1. I Agree
53. Internet Use Policy
    Children 17 and under must have parental permission to use the library's internet computers. A parent or legal guardian must sign the following internet permission form at the library in the presence of a staff member. Parents/guardians of minors are responsible for supervising and monitoring their children's Internet use. Library staff cannot perform this parental function. The library provides facilities but does not take responsibility for the Internet's accuracy, timeliness or appropriateness. Users are responsible for evaluating the materials that are accessed. Much of the information retrieved may be inaccurate, offensive to some, or inappropriate for children. Parental guidance is offered in a publication called Child Safety on the Information Highway. Available at www.safekids.com
Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field