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2. First Name*
3. Last Name*
5. E-Mail Address*
7. What do you need?

   Check as many as apply.

   1. I have a library card but don't know my number or password
   2. I need a new library card*
   3. I need to know how to use my library card online
8. Residency*

   What town do you live in?

10. Permanent Library Card

    Residents of Colchester are eligible for permanent status. Please send us photo ID and proof of residency with your security email.

12. Age Range

    1. Child under 16
    2. Teen 16-18
    3. Adult
13. Birthday (under 18)
    Birthday (under 18)
15. Security Question*
    Send a separate email to the library [burnhamlib@colchestervt.gov] with the phrase you type above. This is to ensure we send information to the right email address. Thank you.
17. Send me a copy of my response.*
Leave This Blank:


19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit

* indicates a required field