SPONSOR'S NAME (LAST, FIRST, MI) GRADE / RANK CARD NUMBER (TO BE FILLED IN BY LIBRARY STAFF)  
     
  SQUADRON / UNIT (AT GOODFELLOW AFB)
SQUADRON / UNIT (HOME STATION IF TDY)
  
 
 
  MAILING ADDRESS DUTY PHONE  
   
  CITY STATE ZIP HOME PHONE  
   
  EMAIL ADDRESS (MILITARY OR COMMERCIAL)  
   
  ESTIMATED DEPARTURE DATE (Student and TDY Personnel Only)  
   
  MILITARY  DEPENDENTS AUTHORIZED TO USE THIS CARD  
   
   
  I CERTIFY THAT I AM RESPONSIBLE FOR ALL MATERIALS CHARGED ON MY LIBRARY CARD.  
  DATE SIGNATURE  
       
  PRIVACY ACT STATEMENT  
  AUTHORITY: 10 US CODE 8013 and EO 9397.  PURPOSE: To register authorized personnel desiring to use library facilities.  USE: Used to identify all authorized personnel desiring to use the library and its resources.  If information is not filed in the Base Library, individual's card would not be in registration file for library resources.  Unless required information is provided, individual would not be able to use the library.  
  LIBRARY STAFF USE ONLY  
  DATE ENTERED IN SYSTEM LIBRARY STAFF MEMBER SIGNATURE  
       
      LIBRARY REGISTRATION