First Name

Last Name

Email

Phone

Address

City

State

ZipCode

Drivers license number

Alternate contact name (in case your details change)

Alternate contact number

How did you hear about us Flyer
Newspaper
Facebook
Website
Member referral
Other

How many children under 8 do you have

Ages 0
1
2
3
4
5
6
7
8

Gender Male
Female
Prefer not to say

Please list any skills that you or your partner may be able to share with the Toy Library Committee (eg. painter, electrician, handyman, fundraising skills etc.)

Type of membership Duty Member ($70) Non-duty Member ($160) Committee Member ($30)

Preferred duty day Tuesday
Saturday

Payment Type Credit Card

Total Amount

Please read and tick to acknowledge your understanding I agree to abide by all rules of the Orana Toy Library and have read and understand the terms and conditions
I agree to have my telephone number displayed on the Orana Toy Library Roster