Fillable Jacksonville State University SPECIAL PERMIT CHECK-OUT CARD (Jacksonville State University)

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Jacksonville State University SPECIAL PERMIT CHECK-OUT CARD (Jacksonville State University)

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Jacksonville State University
Houston Cole Library
(256) 782-5758
Application for
SPECIAL PERMIT CHECK-OUT CARD
NAME _______________________________________________________________
MAILING ADDRESS ____________________________________________________
____________________________________________________
EMAIL ADDRESS ______________________________________________________
HOME PHONE _________________________ CELL _________________________
DRIVER’S LICENSE# _________________________ ISSUING STATE _________
I understand I may check out 5 books, agree to return all books
checked out to me on or before the due date, and pay any overdue
charges. I also understand that the Library has the right to recall
any book I may have if needed by a JSU student, faculty, or staff
member. If I lose a book, I will pay the replacement cost, plus cost
of processing. I also understand that I will forfeit the privilege
to use my SPECIAL PERMIT CARD if I do not return books when due.
Signature ______________________________________ Date _____________
$30.00 fee for SPECIAL PERMIT CARD payable before the permit will be
issued. The fee is payable to Houston Cole Library.
Paid __________________
revised 10-2014
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Jacksonville State University SPECIAL PERMIT CHECK-OUT CARD (Jacksonville State University)

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Completed 21 August 2020

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