Get a Library Card

Your Info

Your Name/Nombre*:

Street Address/Dirección*:

Town/Cuidad*:

Zip Code/Código Postal*:

Phone/Teléfono*:

Email*:

Birthdate/Fecha de Nacimiento*:

*As a resident of Center Moriches School District, I hereby apply for the right to use the Center Moriches Free Public Library and promise to obey all of its rules and give immediate notice at the Library of any change of residence.

Other Household Members

Name:

Birthdate:

Card Number:

Name:

Birthdate:

Card Number:

Name:

Birthdate:

Card Number:

Name:

Birthdate:

Card Number:

I understand that by submitting this form, I agree to the following*:

• I am at least 18 years old.
• I am a resident of either the Center Moriches, Eastport-South Manor, East Moriches, Speonk, or Remsenberg school districts.
• If I am not a resident of Center Moriches but a resident of one of the others listed above, then I agree that my entire household wants a library card with the Center Moriches Free Public Library. I understand that I may have an option to join Mastic-Moriches-Shirley, Westhampton, or Riverhead public libraries, and choose to join Center Moriches.
• If I have a choice of libraries, I understand that my card will expire June 30th of every year, when I will have a chance to change libraries or renew with Center Moriches.