University Library > Policies > Guest Pass Application

UW-W Andersen Library Guest Pass Applications

Completion of this application provides the bearer of the Guest Pass access to the library's on-line electronic resources. Abuse of the posted Library Computer Use Policy will result in IMMEDIATE AND PERMANENT SUSPENSION of these privileges. Individuals under the age of 18 are required to have their parent or legal guardian fill in the bottom of this form and return it to the library circulation desk. A library staff member will contact your parent or guardian before issuing the guest pass. If we have no problem contacting your parent or guardian, the pass will be available within 2 working days (Monday - Friday).

Guest Pass users can only use the workstations in the Reference Alcove area and only when there is a Reference Librarian on duty. Please check in with a Reference Librarian before using the facility.

There is a $3 replacement charge if you lose the card.

Name _____________________________

(please print)

Address_______________________________________________________________

Street City State Zip

Phone Number_________________________

Signature_______________________ Date ___________________________

Parental Approval

By signing this application you are assuming responsibility for the actions and behavior of your child while using the library's electronic resources. This could include responsibility for damages to computers and peripheral equipment or liability for charges brought for inappropriate behavior on the Internet. Please read the Library Computer Use Policy on the reverse side.

Name ____________________________

(please print)

Address_______________________________________________________________

Street City State Zip

Phone Number_________________________

Signature_______________________ Date ___________________________