Required fields are marked with asterisks (*)

Cerritos Library Card Registration Form for New Membership

Please fill out a separate form for each library card.

Patron Type

Child (0-12)

Young Adult (13-17)

Adult (18-59)

Senior (60+)

Last Name

First Name

Middle Name

Street Address

City

State

ZIP Code

Contact Phone Number

Email Address

Date of Birth

California Driver's License Number/ID (Parent's Information for Minor)

Name of School (for non-residents that qualify for free cards)

Name of person authorized to pick up items you have placed on hold

Parent Name (for minors)

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