Application Form
Currently open only to residents of Greentown, Paupack and Tafton
Yes, I would like to participate in the Library By Mail program. (* Required information)
Name: (please print)
*
Mailing Address:
Address:
* If mailing address is a P.O. Box number, include your street address.
City:
State:
Zip:
Township:
Telephone:
E-mail:
Yes, I have a valid PCPL card.
Here is the barcode #:
If you have an old six-digit Pike County Public Library card or have never had a PCPL card, we will issue you one, but you must also enclose proof of Pike County residency with this form. A copy of any of the following documents will be sufficient:
• Your Driver's License • Utility Bill (Phone, Gas, Electric, etc.) • Property, Lease or Rental Agreement
Please mail this form plus proof of residency (if necessary) to:
Library By Mail, Pike County Public Library, 201 Broad Street, Milford, PA 18337
Print out this form and mail in.
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