Library Membership

Library Reader Membership Form

Title (e.g. Mr, Ms, Dr) (optional)

First Name

Last Name

Work Department and Address (please include postcode)

Work Telephone / Mobile Number

Work Email

Job Title

Employer

Current Home Address (please include postcode)

Personal Telephone / Mobile Number

Please choose which site you would like to collect your library books from

If you work for LCHS, LPFT or at Louth Hospital, please indicate if you would like us to post your library books to your work address

I would like to receive library notices by

Permanent or Temporary Employment

If temporary when does your contract expire?

If you are a student or apprentice please enter your course provider, course title and course finish date

If you are a student please enter your placement start and end dates (see information at the end of the form)

By completing this form: I agree to this data being held in accordance with the Data Protection Act (DPA) 2018 / UK General Data Protection Regulation (GDPR) for use in any relevant local library systems and in a system shared by NHS libraries in the Midlands. I agree to the Heath Libraries Midlands Terms and Conditions. I agree to abide by the Library and Knowledge Services’ regulations, as detailed in the Library Users’ Charter.

Address

Thank you - your membership request has been sent.

Students on placement

Please note that LCHS, LPFT and ULHT placement students may only join the library and borrow books for the duration of their placement(s) with the named Trusts.

Please contact your local library if you have any subsequent placements so that we can update your library record. You do not need to re-register each time unless your course and/or university changes.

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