SUBASE NLON LIBRARY REGISTRATION FORM

Only ONE library registration form per family.

4 books, per sponsor/family member. 3 DVDs per family.
BOOKS are checked out for 3 weeks / DVDS are checked out for 3 days / Video games are
checked out for 1 week, 1 game per family. You CAN renew library materials over the phone.
The SPONSOR must complete all information.
Your ID must be presented with this form.

The Sponsor is the Active Duty Member, DOD employee,

Retired member, Contract employee.
SPONSORS NAME (LAST, FIRST, MI):
_______________________________________________________________________
RANK/RATE: _________ MILITARY BRANCH: ________DOD ID number: ______
DUTY STATION/DEPARTMENT: _________________________________________
WORK PH #: __________________CELL/HOME PH #________________________
EMAIL ADDRESS: ______________________________________________________
LOCALHOME ADDRESS / BARRACKS BLDG. AND ROOM #:
________________________________________________________________________
________________________________________________________________________
LIST FAMILY MEMBERS AUTHORIZED TO USE LIBRARY:
________________________________________________________________________
________________________________________________________________________
Borrowers are responsible for the safety, proper use and timely return of all damaged
materials and equipment. Current replacement costs will be assessed for all lost and / or
damaged materials, including damaged caused by your equipment. Your military pay can be
garnished for payment.
PRIVACY ACT STATEMENT: Information requested is solely for use of the NAVSUBASE
NLON staff to contact you regarding library matters.
SIGNATURE: __________________________________________ DATE: __________
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LIBRARY ID # ___________________ STAFF SIGNATURE ___________________