Faculty/Staff Spouse/Domestic Partner  Borrower's Card Application

A Faculty/Staff Spouse/Domestic Partner Borrower’s Card will allow you the same check-out privileges as an EKU staff member. For borrowing guidelines, please refer to the Faculty/Staff Spouse/Domestic Partner Borrower's Guidelines.
To obtain a card, please complete the following form and bring it to the Circulation Desk. A copy of your current driver’s license or other valid I.D. is also required to complete this application. The fields with * are required.
Borrower Information
Applicant's First and Last Name:	*
Address:	*
City:	*
State:	Kentucky
Zip Code:	*
Phone:	*
E-mail Address:
Spouse's/Domestic Partner's Name:	*
Spouse's/Domestic Partner's EKU ID#:	*
Agreement/Authorization
My signature below indicates that I have read and agree to comply with the Faculty/Staff Spouse/Domestic Partner Borrower's Guidelines.
____________________________________ Spouse's/Domestic Partner's Signature	____________________________________ Date
____________________________________ Applicant's Signature	____________________________________ Date