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2. First Name*
3. Last Name*
5. Phone Number*
7. Email Address
9. Enter your library card number (14 digits)*

   This form is for renewing Madison Heights library cards only.

11. Do you need to update your address?*

    1. Yes
    2. No
13. Address
14. Zip Code
16. Do you need to update your phone number?*

    1. Yes
    2. No
18. Phone Number
19. (If Mobile Phone) Who is the Cell Phone Carrier?
21. Do you need to update your email address?*

    1. Yes
    2. No
23. Email Address
25. Notification Preference*
    -- Select One --EmailPhone CallText Message

    Select one.
27. Do you want a replacement card?*
    -- Select One --YesNo

    If yes, your library card number will change.

29. 3 library card styles are available:

    1. 1 - Open Book with Rainbow
    2. 2 - Colorful Books
    3. 3 - Dragon - Read to Explore

    

    
    

31. Do you use the Libby app?*

    1. Yes
    2. No
    3. I'm not sure

    We will need to merge your old and new library card numbers so you don't lose your place on holds.

33. A library staff member will contact you once your card has been renewed.

    If we receive your request outside of regular business hours, you will hear from us on the next business day.

Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field