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Organization Card Application

  1. First, Middle, Last
  2. First, Middle, Last
  3. First, Middle, Last
  4. First, Middle, Last
  5. First, Middle, Last
  6. 4 to 10 digits using letters and/or numbers only, (no special characters or symbols).
  7. Submission Statement
    By submitting this form electronically you are stating that you are an authorized representative for your organization, you are requesting an Anoka County Library Organization card by email, and you agree to be responsible for any material borrowed on this card.
  8. Leave This Blank:

  9. This field is not part of the form submission.