Form Center

2. Thank you for your interest in becoming a member of the Powhatan County Public Library.

4. Patron Information

   1. I am an adult (18 years old or older)

   _{PCPL does not offer online registration for juvenile (under 18) patrons. Juvenile cards must be authorized by a parent or legal guardian with a PCPL library card in good standing. Please visit the library to fill out a paper form for a juvenile card.}

5. Powhatan County Government Employee?

   1. Yes
   2. No
7. First Name*
8. Middle Name
9. Last Name*
10. Date of Birth*
12. Mailing Address*
13. City*
14. Zip Code*
16. Primary Phone Number*
17. Email Address*
19. I would like to receive hold notices & courtesy overdue notices by:

    1. Email

    1. Phone
21. Wowbrary

    Once a week Wowbrary will email PCPL patrons with the newest bestsellers, DVDs, books and audiobooks. Wowbray is a free service provided by PCPL.

    1. Do not send me emails about new books, DVDs and audiobooks in the library.
23. Statement of responsibility

    I accept responsibility for all materials borrower, fines charged, and any loss or damage, whether intentional or unintentional, to library property, including public use computers or any related hardware or software provided by the library.

25. Electronic Signature*

27. Please allow 5-7 business days for online card processing. If you need your card sooner, please visit the Library to complete a print application.

29. Blessed Sacrament Parents
    Printable PCPL Registration Form (PDF)

    If you are filling this form out for your child's upcoming visit to the library, and have trouble submitting the form, we do have a PDF available to print out.

    If possible, please email a scanned copy of the completed form to library@powhatanlibrary.net. Otherwise, please send the form with your child on the day of their class visit.
    
    Thank you. We apologize for the inconvenience.

    
    

Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field