Library Card Registration Form

  First time registration        Change of information

Last Name:

First Name:       Middle Initial:

Student Identification Number / UA ID (if known/available):

Driver's License / State ID Issuing State:      Number:

Mailing Address:

P.O. Box or Street Address:

City:         State:

Zip Code:

Home Phone:

Work Phone:

E-mail Address:

The campus you are taking the majority of your classes through (if you are a distance education student):

UAS - Juneau      UAS - Ketchikan      UAS - Sitka

UAA      UAF      multiple / other (explain in comments)

Comments: