Trafford Council

Surname*

First name* (please provide full name)

Title

Select... Mr Mrs Ms Miss Dr Other

Other Title (please specify)

Date of birth* (dd/mm/yyyy)

Address Line 1*

Address Line 2*

Address Line 3

Town/City*

Postcode*

Telephone number

Mobile number

School/College (if under 18)

If any of your personal details change, please inform Trafford Libraries.

Where did you find out information about Trafford Libraries?*

Select... Poster Leaflet Website Newspaper/magazine Personal recommendation Other

Other information (please specify)

Home Library

Please select a Home Library (the one you are most likely to use)*.

Select... Altrincham Bowfell Coppice Avenue Davyhulme Greatstone Hale Home Library Service Local Studies Lostock Mobile Library Service Old Trafford Partington Sale Stretford Timperley Urmston Woodsend

Please select one of the following:*

About You

It will help us if you will take the time to give us information about yourself. All information will be treated confidentially. This information will also be used in the future to help improve library services to users across Trafford.

Gender*

Select... Male Female

Ethnic background
.
Please select the option that you feel best describes your ethnic background.

Asian

Other Asian background (Please specify)

Black

Other Black background (Please specify)

Chinese

Other Chinese background (Please specify)

Mixed Background

Other Mixed background (Please specify)

White

Other White background (Please specify)

Other Ethnic

Other Ethnic background (Please specify)

Which language do you consider to be your first spoken language?

Other spoken language (Please specify)

Which language do you consider to be your first written language?

Other written language (Please specify)

Disability

The Disability Act defines this as a 'physical or mental impairment which has a substantial and long term adverse effect on a person's ability to carry out normal day-to-day activities'.

If this applies to you, does your disability affect your:

Other disability (Please specify)

Your library card will be available for collection/posted to your address within 7 days of the receipt of your application and will be accompanied by a New Members' Information pack.

Please look after your card - do not lend it to another person. If you lose it, please inform any Trafford Library.

Would you like to be informed about specific services offered by Trafford Libraries?

Select... Yes No

Your details will be treated confidentially as required by the Data Protection Act.

To place reservations on our catalogue and use our PCs you must first acquire a PIN (Personal Identification Number) from a member of staff in any Trafford Library. You will need to show one form of ID to get your PIN.

By submitting this form you will be considered to have agreed to act appropriately in any Trafford library.

Submitting this form does not result in automatic membership of Trafford Libraries and we reserve the right to refuse applications made in this way.

Please print a copy of this form for your own records.