Patron Application

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This form is processed Monday - Friday, 7:30am - 4:30pm. Turn around time is usually within 24 hours.

Questions? Contact the Access Services Department, (915) 747-5672, for more information.

Type of Application
(check one):

New application

Update

Patron Category:

Patron Information:

Date:

Name (Last, First, Middle):

UTEP ID:

Date of Birth:

Department or Major:

Campus Address (faculty/staff):

Campus Phone (faculty/staff):

UTEP Email Address:

Local Address - Street:

City / State:

Zip:

Phone:

Permanent Address (if different from above):

Street:

City / State:

Zip:

Phone: