Library Card Number............. ______________________
Library PIN________ Library City and State____________
Total overdue fines in the past 10 years.... $__________.
Any books currently overdue? cYes cNo If yes, how many? ______
How many hours per week do you watch television? _____________
How many hours watching professional sports? .................
Do you have cable TV? cYes cNo Satellite dish? cYes cNo
To what newspapers do you subscribe?_____________________
Which section do you read first?__________________________