Library card application First name MIKE Last name ESPOSA-HERNANDEZ Date of birth 08/11/1991 Address 4 CHARLES ROAD, GLOUCESTER Postcode GL1 3ZE Phone 07796 345678 Email m.esposa@example.com I declare the information provided is correct. Signature Mike Esposa-Hernandez Date 03/07/2018 Your checklist Have you got everything you need? [ ✔ ] a passport photo [ ✔ ] a copy of my passport or other photo ID [ ✔ ] proof of address Your card will be issued within 15 days and sent to the address provided.