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Community College of Rhode Island Library

Distance Learning Services - Library Card Application
This application is for students who are only enrolled in Distance Learning courses.  If you can travel to CCRI, please visit one of the campus libraries to have your Student ID activated as a library card.

If you cannot travel, please complete the following information.  Whenever possible, we will email you your activated library card number within one business day.

* required field
* First Name:  
   Middle Name:  
* Last Name:  
* Student ID Number:    
* Email Address:
   (CCRI email preferred)		  
   Alternate Email Address:  
* Phone Number:  --

* Home Address
                                                           

Street:  

City:         State:      Zip Code:  
  Mailing Address (if different from home
  address)

Street: 

City:         State:      Zip Code:  
* Distance Learning course(s) enrolled in:
   (e.g., ENGL 1300-600)  		 
* Age:

 		  

NOTE: Students under age 18 must have a parent or guardian sign this form

* Please choose one:  I agree   or    I don't agree

to abide by the library's rules and regulations and to be responsible for material charged out to me.  I understand that failure to return materials borrowed may result in a $100 fee per item, the loss of library privileges and the withholding of grades, transcripts, diplomas, and/or registration.

* Please type your name to act as your signature:  
 

If under 18 years of age:  

   Parent/guardian signature:

  

 
   Parent/guardian email address:  

 Comments:


 

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