Online Application for a Library Card

First Name*
Middle Name or Initial*
Last Name*
Parent/Guardian Name (required if applicant is a minor)
Street Address*
Please list your physical address if different from your mailing address.
City/State*
ZIP code*
Primary Phone Number*
Secondary Number
Date of birth*
Your email address*
Township in which you live*
Select your preferred HCPL branch*
Your Indiana Drivers License Number OR your Social Security Number*
Attach a copy or photo of your Drivers License. If your license does not show your current address, also attach a copy or photo of a recently postmarked piece of mail that shows your current address.*
Drop files here or
Consent*
- Yes
- No
By clicking "Yes" I agree to take full responsibility for any and all materials checked out under this account. I understand that only the person named on this account can use it. If this account is for a minor, I, the parent/guardian, take full responsibility for the items checked out under this account.

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