Uxbridge Free Public Library - Uxbridge, MA
Application for C/W Mars Library Card
First time C/W Mars cards are issued free of charge.  Replacement cards will be $ 1.00.

Identification and proof of current address required for all adult registrations.  Patrons age 14
and under must have adult with proof of current address with them.
Please list any Massachusetts library for which you have a library card:
MI
M
F
I agree to be responsible for materials borrowed with this card, including all fines incurred and for
any lost or damaged materials.  The Uxbridge Free Public LIbrary cannot be responsible for the
content of any material borrowed by a minor child.
Signature of Applicant
Date
Parent or Guardian Signature for Borrowers Aged 14 and Under (Required)
Date
PRINT  *  SIGN  *  BRING TO THE LIBRARY WITH PROPER IDENTIFICATION
Last Name:
 First Name:
Street Address
Mailing
City
State
Home Phone:
 Name listed under
Work or Cell Phone
Year of Birth
 Gender:
Email Address: