Transcript Slide 1

DBS Library – Application for External Membership
External Member number:
Title: Mr/Mrs/Ms /Miss/Dr
Have you been referred by a friend?
Yes
1 Year Membership (€90)
6 Months Membership (€60)
3Months Membership (€45)
No
If yes, please enter their name below:
________________________________
(USE BLOCK LETTERS PLEASE)
Name:
Date of birth:
___________________________________________
_____________________________________
Address:
_________________________________________________________________________________________
_________________________________________________________________________________________
Phone:
_____________________________
Email Address:
__________________________________________________
Related Institution/Company:
__________________________________________________________________________________________
Purpose of membership:
__________________________________________________________________________________________
Area(s) of interest:
__________________________________________________________________________________________
An External Member can access all library resources at both library sites and can borrow up to 4 library items for a two week period with an option
to renew up to 5 times. External Borrowers also have off campus access to Dawsonera (DBS Library e-book collection).
The cost of each membership is outlined above and must be paid in full before members avail of the relevant library services. These fees are nonrefundable.
* External Members who subscribe to a 1 year membership may renew their membership for another year at a reduced fee of €60.
6 month and 3 months External Members must pay the same fees again if they wish to renew their membership.
The Library Code of Conduct and Rules & Regulations apply to all users and are available in the Library or upon request. I agree to the above terms
and conditions:
Signed: __________________________________________________________
Office use:
Date: _________________________________________________
Please note that you also need to provide 1 passport-size photograph with this form
(this can be an original photograph or a digital copy)
Date entered on Koha: _________________________________
Expiry date of membership: _______________________________
Staff name: ________________________________________
Date paid: _________________________________________