Register for a Library Card

After submitting this form, please visit the Waterloo Public Library to pick up your card.

Last NameRequired

Middle Name

First NameRequired

Date of Birth (MM/DD/YYYY)Required

AddressRequired

Address 2

CityRequired

StateRequired

Zip CodeRequired

Primary Phone (xxx-xxx-xxxx)Required

Primary EmailRequired

Secondary Phone (xxx-xxx-xxxx)

Other Phone (xxx-xxx-xxxx)

Secondary Email

Alternate Address

Address 2

City

State

Zip Code

Country

Phone (xxx-xxx-xxxx)

Contact Notes

PIN/PasswordRequired

PIN must be 4 digits.

Confirm PIN/PasswordRequired