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Illinois Library Card Form
OF eMpLoyMeNt:
cIty/zIp coDe
n Full time
teLephoNe NuMber
Fax NuMber
e-MaIL
staFF use oNLy: goverNMeNt aFFILIatIoN
1. ______________ gs
3. ______________ Ls
2. ______________
gv
n contractual
ending Date _________________
n temporary
ending Date _________________
n Intermittent
ending Date _________________
n other
ending Date _________________
staFF use oNLy:
Library card expiration Date:
I hereby accept full responsibility for any library materials borrowed on this Illinois...
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