Library Registration Form

Committed to Education

If you are a member of staff of the Western Sydney Local Health District or a Western Sydney University medical student (Years 3-5) you may join our library.

You may do this online, by completing the online library registration form below, or by visiting any of our facility libraries and registering there. Membership is free.

Your Details

Facility* - required Blacktown Hospital Mount Druitt Hospital

Title* - required

First name* - required

Last name* - required

Gender* - required

Email address* - required

Mobile Phone Number* - required

Work Phone Number* - required

Home Phone Number

Pager Number

Home Address* - required

Suburb* - required

Postcode* - required

Password to access library membership and renew/reserve items online* - required

I am an employee of Western Sydney Local Health District working at Blacktown Mount Druitt Hospital and Community Health Centres Yes

Employee Number

Position Title

Department

I am a Western Sydney University Medical Student Yes

Student ID Number

Year

Declaration

I authorise Western Sydney Local Health District, Nepean Blue Mountains Local Health District and the Sydney Children's Hospitals Network library staff to use these details to contact me in regards to library matters. I am aware that I can ask library staff to view or update my details. I agree to take full responsibility for any items borrowed on my membership and will pay the fee incurred for lost, damaged or overdue items. If utilising the online document delivery system I agree to adhere to the principles of fair dealing as stipulated in Section 49 of the Australian Copyright Act. I understand that all documents requested electronically are subject to copyright & that the last 5 digits of my library membership number will substitute for my signature when using these forms. If I am an employee, who at the time of my termination of employment with WSLHD has failed to pay any outstanding fines or replacement costs incurred, I authorise the deduction of the outstanding amount from my termination pay. If I am a student, I understand that my exam results will be withheld until all items are returned and fines cleared.

Mandatory field(s) marked with *

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Library

If you are a member of staff of the Western Sydney Local Health District or a Western Sydney University medical student (Years 3-5) you may join our library.

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WSLHD Facilities

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Westmead Hospital

Blacktown and Mount Druitt Hospitals

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