Wake Tech Community College Libraries
Library Account Application - Student
Distance Education - Only for Students taking On-line Classes.
DATE
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Month
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Day
Year
Date Picker Icon
Student ID Number
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Student Name
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First Name
Middle Initial
Last Name
Date of Birth
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Month
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Day
Year
Date Picker Icon
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
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Select Campus:
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Please Select
Main
North
Health
Public Safety
West
Phone Number (Primary)
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Area Code
Phone Number
Phone Number (Other)
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Area Code
Phone Number
Agreement
I agree to observe all library rules and be responsible for all materials borrowed from Wake Tech libraries. I agree to pay all fines and other charges for late returns, loss, or any damage done to all materials charged on your account. This includes items lost or stolen by someone using your unreported lost or stolen Student ID card. I will report the loss or theft immediately. Please notify any of the Wake Tech libraries of any change in address information.
**My signature below indicates acceptance of the terms outlined above.**
eSignature: Please Sign by Using Your Mouse
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