Application for a Library Card

Title(s):

Please enter your title(s) here.

First name: *

Last name: *

Please enter your last name here.

Date of birth: *

Please enter your date of birth here.

Your e-mail address: *

Please enter your e-mail address here.

Street address: *

Please enter your street address including house number here.

ZIP/Post code: *

Please enter your ZIP/post code here.

Place name: *

Please enter your place name here.

University/institution:

Please enter the university/institution you study at:

I am an auditor or senior student at Leipzig University (Please tick only if you are currently an auditor or senior student at Leipzig University.):

Auditor

Senior student

Please select the correct button if you are an auditor or senior student at Leipzig University.

I would like to collect my library card from the following branch:Please tick where youI would like to collect your library card:

Yes *

Please tick here if you have read and accept the rules governing the use of Leipzig University Library as well as the list of fees and charges.

I have read and agree to the privacy statement of Leipzig University Library:

Yes *

Please tick the checkbox to confirm that you have read and agree to the privacy policy of Leipzig University Library.

Fields marked with an * are required fields and must contain data.