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 JanFebMarAprMayJunJulAugSepOctNovDec 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 University Details ULANZ University * -- Please Select --Auckland University of Technology Australian Catholic UniversityAustralian National UniversityBond UniversityCentral Queensland UniversityCharles Darwin UniversityCharles Sturt UniversityCurtin UniversityDeakin UniversityEdith Cowan UniversityFederation University Australia (formerly University of Ballarat)Flinders UniversityGriffith UniversityJames Cook UniversityLa Trobe UniversityLincoln UniversityMacquarie UniversityMassey University Monash University Murdoch UniversityQueensland University of TechnologyRMIT University Southern Cross UniversitySwinburne University of TechnologyThe University of Melbourne The University of New EnglandThe University of New South WalesThe University of NewcastleThe University of Queensland The University of Southern QueenslandThe University of SydneyThe University of Western Australia University of Adelaide¶¶ÒõPornUniversity of Canterbury University of Notre Dame AustraliaUniversity of OtagoUniversity of South Australia University of Tasmania University of Technology, SydneyUniversity of the Sunshine Coast University of Waikato University of Western SydneyUniversity of WollongongVictoria UniversityVictoria University 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 (University 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 ¶¶ÒõPorn Library