Civic Access Membership Application Form

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:

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.

I ACCEPT THESE TERMS & CONDITIONS