Tool Library Membership Application – Home Repair Resource Center

Name*

First Last

Email*

Address Where Tools Will Be Used*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Residential/Mailing Address (if different)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Secondary Phone

Date of Birth*

Driver's License or ID#*

NO Social Security Numbers please

User Name

For our online Tool Catalog. If you choose to create a username and password, you will be able to log onto the catalog and reserve tool, renew tools, or check any balances you may have. If you want this ability, please create a username & password here (keep a record for yourself). 3-25 characters long. LETTERS & NUMBERS ONLY

Password

6-64 characters long with at least 1 letter and 1 number. It cannot contain your username

Consent*

By checking this box, you agree the information in this application is accurate and complete to the best of your knowledge.