MUNICIPAL COUNCIL OF CUREPIPE
CARNEGIE LIBRARY
MEMBERSHIP FORM
MC NO.…………………………………. BODY ID. …………………………………………………..
SURNAME: ……………………………………………………..FIRST NAME: (MR/MRS/MISS) …………………………………………..……………..
HOME ADDRESS: ………………………………………………………………………………………………………………………………………………………….
PLACE OF WORK/ STUDY: …………………………..………………………………………………….OCCUPATION: …………………………………….
TEL. NO. : HOME …………………...MOBILE …………………………………..EMAIL ADD.: ……………………………………………………………
DATE OF BIRTH: (D/M/Y) ……../…..…/………….AGE: …………….. ID CARD NO. …………….…………………………………………….
I wish to join the Library and agree to abide by the Rules and Regulations governing the Library, to pay promptly all fines for the damage or loss of materials and to give immediate notice of any change of address.
Date …………………………………..Signature ………………………………………………….
GUARANTOR
(TO BE FILLED BY PERSONS OVER 18 YEARS)
SURNAME: ……………………………………………………..FIRST NAME: (MR/MRS/MISS) …………………………………………..……………..
HOME ADDRESS: ………………………………………………………………………………………………………………………………………………………….
RELATIONSHIP TO APPLICANT : ………………………….ID CARD NO. ………………………………………………………………………..
OCCUPATION: …………………………………….PLACE OF WORK/STUDY: …………………………..………………………………………………….
TEL. NO. : HOME …………………...MOBILE …………………………………..EMAIL ADD.: ……………………………………………………………
I wish to support this application and undertake to be responsible for any loss or damage which may be caused by the applicant to materials belonging to the Carnegie Library.
Date …………………………………..Signature ………………………………………………….
FOR LIBRARY USE
MEMBERSHIP: JUNIOR/TEENAGER/ADULT
Resident of Curepipe Non-Resident Proof of address submitted
Deposit for ..… Book(s) & ..… Pds. Amount: Rs ………… Annual Fee: Rs …….……Receipt No. …………….…………
Subscription made on:…….../…………/………….Receipt No. ST……………………….…………………….
Processed by: …………………………………………………..
……………………………………………………………………………………………………………………………………………………………………
FOR CASH OFFICE
DEPOSIT FOR LIBRARY MEMBERSHIP
Name: ……………………………………………………………….. Body ID: …………………………………. Amount (Rs)……………………..
Date: ……………………………… Sig. of Library Staff:……………………………………………………………………
CARNEGIE LIBRARY
Membership is open to the public regardless of residential place.
Only a Registered subscriber can borrow books/periodicals.
For members below 18 years, the Application Form must be filled by a parent/guardian.
A completed and signed Application Form must be submitted to the Carnegie Library staff to have your card issued.
Loan period : 21 days
Fine : Re. 1.00 per book per day
Renewal of books :(On or before the due date) By phone on 670 6733 or in person only twice.
Copy of Rules and Regulations of the library annexed.
How to become a member?(Documents to be produced)Children / Students / Adults/Guardian
Birth Certificate / Birth Certificate/Student Bus Pass / National ID Card
+ Any proof of the home address (CWA/CEB Bill)
Library Membership / Membership Fees
Refundable Deposit (Rs) / Annual Subscription (Rs)
Resident of Curepipe / Non-Resident
(Irrespective of number of books)
Per Book / 100.00 / Free / 50.00
For 2 Periodicals / 50.00 / Free / 30.00