Media Library eMail Registration Form

 
Your Name:
eMail:   Format: yname@yourisp.com
Account Number
Parish
Delivery Address Physical Address, no PO Boxes please
Mailing Address If different from Delivery Address
City
State
Zip Code
Telephone Format: 503-233-8371 or 503.233.8371. Please include area code.
Fax Format: 503-233-8371 or 503.233.8371. Please include area code.

Type of Account:  Open or Restricted (If restricted, list authorized users below)

Registered Users:

PATRON   NAME POSITION
1
2
3
4
5
6
7
8
9
10
I am interested in receiving more information about the Resource Center's Annual Fee Program: Yes or No
I am interested in receiving correspondence from the Resource Center by email: Yes or No
I am interested in receiving Resource Center Newsletters and Updates by email: Yes or No
Comments

 
I agree to abide by the policies and procedures as set forth by the Resource Center in the information section
Accept or Decline

Please be patient when mailing this form. It may take several seconds to complete this transaction.  Closing it before it has completely finished can result in incorrect or missing information and transmission errors. Once the form has been sent, click on the "CONFIRM" button to continue. Do not click on "CONFIRM" before you send the form or your request will not be sent.

Thank You for using your Resource Center