Distance Learning Services - Library Card Application

This application is for students who are ONLY enrolled in Distance Learning courses and cannot visit a campus library.

( * = required field in form below)

Please provide the following information:CCRI barcode:Home address:Mailing address (if different from home address):Note: Students under age 18 must have a perent or guardian sign this form.If under 18 years of age:

This page developed and maintained by the CCRI Library. Send comments and suggestions to epenta@ccri.edu.

Last Updated: 11/16/16