Civic Access Membership Application Form

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Please complete this form fully to apply for Library Civic Access membership.

Successful applicants will receive confirmation by email.

Apply for Ulster University Library Civic Access membership:

Required fields are marked with an asterisk (*).

Your Contact Details

Title

Forname *

Surname *

Date of Birth *

Day Month Year

Address Line 1 *

Address Line 2

Town/City *

Postcode *

Home Telephone No.

Work Telephone No.

Email Address *

Libraries NI Member Card No. *

Terms and Conditions

Please accept the following terms and conditions * I confirm that I wish to apply for Ulster University Library Civic Access membership. I agree to abide by the rules of the Library and will be responsible for any fines incurred or charges related to the replacement of items not returned. I agree that the information supplied via this form will be shared with Libraries NI. I agree that Libraries NI will share membership information with Ulster University in relation to this scheme.