Educator Card Application

Complete this application and click the submit button. All applicants agree that they are an educator in New York State and will abide by the rules governing the Brooklyn Public Library.


* Required

Educator Name
* First Name:  * Last Name:
Middle Initial:   Suffix:  
Home Address
* Street Address: Please include apartment #'s where applicable
* City: * State: 
* Zip Code:
School Information
* School Name:
Other:
*School Address:
Address 2:
* City: State:  NY
* Zip Code:
Educator Contact
Notice Preference:
* Email address:
* Confirm email:
* Phone number: XXX-XXX-XXXX
 Cell number: XXX-XXX-XXXX
  (Email address required)
Other
* Birthdate:
   
* Card Delivery:
Verification

By clicking the Submit button, I confirm that I have read and agree to abide by the policies of Brooklyn Public Library.