City of Providence IDPVD Application

APPLICANT INFORMATION

First Name*

Middle Name

Last Name*

Suffix Name

Email*

Current Address*

City

State

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Mailing Address*

City

State

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Phone No.:*

IDENTIFYING INFORMATION

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Are you a Providence Public School District student?

Yes
No

I understand that my Providence Municipal ID will function as a Providence Library Card, and I hereby apply for borrowing privileges at all participating OSL libraries. By signing my card I agree to comply with the policies of each member library with which I do business. By becoming an OSL library cardholder, I accept the following responsibilities:

All library materials checked out on my card are my sole responsibility.
I will return all borrowed items by the due date or pay overdue charges.
I will pay replacement and processing costs assessed for lost, unreturned, or damaged materials.
I will not lend my card to others.
I will promptly report any change in my address or contact information to the Providence Vitals Office and Providence Libraries.
I will promptly report if my card is lost or stolen to the Providence Vitals Office and Providence Libraries.
If signing a library card application for a minor, I accept responsibility for fines and charges on said child’s card and acknowledge that it is my responsibility, not the library’s, to monitor and approve my child’s choice of library materials and/or other information resources.
I understand that failure to act responsibly may result in suspension of my library borrowing and use privileges, and that failure to pay library fines or return library materials may result in legal action.
I understand that failure to act responsibly may result in suspension of my library borrowing and use privileges, and that failure to pay library fines or return library materials may result in legal action.
I agree to abide by state library laws and local library regulations and understand that I am responsible for all materials borrowed with my card.

I hereby state that the information supplied in this application above is true and that I am not in violation of Section 23-3-28 of the General Laws of RI:

Section 23-3-28 of the General Laws I understand that Section 23-3-28 of the General Laws of Rhode Island provides penalties for either of the following violations: Any person who willfully and knowingly makes any false statement in a report, record, certificate or application for an amendment thereof, or who willfully and knowingly supplies false information intending that such information be used in the preparation of any of the such report, record, or certificate, or amendment thereof shall be punished (if convicted) by a fine of not more than one thousand dollars ($1,000) or imprisoned not more than one (1) year or both.

Name

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City Of Providence

Mayor Brett Smiley

IDPVD

APPLICANT INFORMATION

IDENTIFYING INFORMATION

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