University Park Campus - Library Card Registration Form

USC University Park Campus

Library Card Registration Form

(Subject to verification)

* Required information

* E-mail address :


* Last Name :	* First Name :	Initial :


* Social Security Number :

* Address 1 (USC Department or School Program) :

Undergraduate MS MD Ph.D. Staff Faculty
Other, Specify:


Major Program Name :	* USC Department :

UPC Faculty Address :

Mail Code :


UPC Faculty Phone & Extension :	Fax Number :

Address 2 (Current, local mailing address while a student at USC) :

Number and Street Name :

Apartment / Condo / Suite No. :


City and State :	Zip Code :


Current Phone Number :	Beeper / Pager Phone Number :

Address 3 (Permanent mailing address if different from above, Address 2) :

* Number and Street Name :

Apartment / Condo / Suite No. :


* City and State :	* Zip Code :


* Home Phone Number :

Use of your library card signifies agreement to comply with all University of Southern California and Health Sciences Libraries regulations and policies. This library card is non-transferable and you are responsible for all use made of this card. I understand I must present University ID at the Wilson Dental Library to activate this application.

* I agree. Yes