YOUTH Application
Mission Viejo Library
17 years and younger
Acceptable forms of identification:
See back for necessary requirements
Choose one:

CARD


Keychain CARD
California Driver’s License
Please print clearly
T H IS S E C T IO N IS U S E D F O R S T A T IS T IC A L P U R P O S E S
Check one:
Check one:
 Age 5 and under
 Age 6 - 12
 Male
 Female
 Age 13 - 17
California I.D.

Last Name _________________ First Name _________________ MI ____
With proof of local address, these will also be accepted:
U.S. Passport

Birthdate ________/_______/________
Month
Day
Year
Military I.D.

Out of state Driver’s License or I.D.

PRINT Parent/Legal Guardian Name: _____________________________
Medicare Card

CA Driver’s License or State ID#: _________________________________
Address __________________________________________________
City ____________________________ State ________ Zip _______
Proof of current address:
(Santa Ana residents are required to pay a $25 per year fee, per library card)
Primary Phone (_____) ____________________________________

California Driver’s License
Notification: (courtesy pre-overdues, holds pick up, overdue notices…)

 Text Message* / Cell Phone (_____) _______________________
*Charges
from your text message provider could apply
Internet Access - For minors 17 and under
The Mission Viejo Library’s Internet access is filtered, however, parents or guardians are still
responsible for monitoring their child’s use of the Internet, and may designate if their child can
have access to the Internet.
Yes, my child does have my
No, my child does not have my
permission to use the Internet at the
Mission Viejo Library
permission to use the Internet at the
Mission Viejo Library
I promise to comply with all library rules and policies and I accept complete
financial responsibility for all materials borrowed with this card.
Required Guardian Signature ___________________________________________
Report lost cards and address changes to the library immediately
California I.D.

 Email ________________________________________________
Utility bill

Personal checks

Car registration

Lease agreement
Library Use Only:
Initials: _________________
Identification:
CA ID
Address:
ID
Family Group ID:
Out of State ID
Check
Utility
Other _____________
Other _____________