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ID/Library Card Application

Please take a moment to complete the following form. Carefully review each question.

If you need additional information, contact:

Library Card Contact	Student ID Contact
Sue Phillips suephil@mountainstate.edu	James McGee jmcgee@mountainstate.edu
304.929.1534	304.929.1351
800.766.6067, x1534	800.766.6067, x1351

Red text Indicates required fields.

Student ID Number:
First Name:
Middle Name:
Last Name:
Mailing Address:
City:
State:		Zip:
Home Phone:
E-mail Address:

Identify your program of study:

Check here if you would like to have a student id in addition to a barcode
Checking this option requires you to email studentids@mountainstate.edu a jpeg image of yourself so that it can be placed on the Student ID. If you have questions please contact James McGee at 1.800.766.6067 ext 1351

Mountain State University • PO Box 9003 Beckley, WV 25802

THIS SCHOOL IS AUTHORIZED UNDER FEDERAL LAW TO ENROLL NONIMMIGRANT ALIEN STUDENTS.