Library Registration

Library Registration form

Please fill out this online form and present your ACT Health ID to join the library. To register for fee based membership, please visit the ACT Health library during business hours.

1. Your First Name*

2. Your Surname*

3. What is your Work Department Name and Address?*

4. Your best Contact Phone Number (Work or Mobile)*

5. Your E-Mail Address (@act.gov.au preferred)*

6. Your Employment Status*

7. Non-permanent staff End Date

8. I am registering in the Library and can show my ACT Health ID* Yes - Skip to Step 10
No

9. Please upload a scanned copy or photograph of the front side of your staff ID badge

10. Copyright Declaration

11. I agree to abide by the rules and policies of the Library and the copyright declaration above*

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Last modified: 19 September 2019.

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