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Digital Access Card Application

2. <span style="color: rgb(255, 0, 0);"> If you are 17 and younger, check out the</span>&nbsp;<a href="https://www.baytown.org/FormCenter/Library-5/Digital-Access-for-Students-125">Student Digital Access Card.</a>

   If you are 17 and younger, check out the Student Digital Access Card.

4. Birthdate*
   Birthdate

6. Last Name*

8. First Name*

10. Middle Name*

12. Street Address*

14. City*

16. Zip Code*

18. Email*

20. Confirm*

24. Upload Proof of Residency*

    Upload a photo or screenshot with your name and address. It can be a picture of a paper or online utility bill, car insurance registration or catalog mailing label.

28. Questions or comments?

Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field