Direct Access Library Card Application Form

*indicates required field
Full Name*

e-mail Address*

Phone Number*

Street Address*

Street Address 2

City*

Zipcode*

Please enter the library card number on your current card

Is the applicant under the age of 18?
Yes, the applicant is under the age of 18.No, the applicant is 18 years or older.

Please upload a photo of your card from your home library in Nassau County.*

Please upload valid, current proof of residency* (PDF, JPG, JPEG, PNG)
eg. driver's license, student ID, bank statement, utility bill, pay stub, etc. Please make sure all attachments are not password protected before submitting!

Please only click once!

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