LRC - LRC Card Request

Register for an LRC Card
Please fill out the information below in order to received an LRC card and/or an AVL card. You may come by the LRC to pick up the card, unless other arrangements are made prior to issuance.

I would like a LRC card.
I would like an AVL card.

Confidential Patron Information

Last Name*	First Name*	Middle Initial*

Home Address*

City*

State*	Zip*


Phone	Email Address


Last 4 digits of Student Number*	Campus attending*


	* Fields Must Be Filled!

LOCATIONS/CAMPUSES/DIRECTIONS | 1-800-543-2426 | WEBMASTER | DISCLAIMER | QUESTIONS