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LIBRARY REGISTRATION FORM
You will receive a reply within 2 working days. If you don't receive an email within this time please contact the library.
library.blackburn@elht.nhs.uk

Fields marked * are required

* Indicates required field

Title *

Name *

First

Last

Date of birth *

Gender: *

Job Title *

Department *

Trust Email *

Personal Email *

Site or Base *

RBTH BGTH Community (please specify) Other (please specify)

If other *

Please specify your site or base if not RBH or BGH

Employing Organisation or University (if on placement) *

ELHT UCLAN Lancaster University Other (please specify)

If other *

Please specify employing organisation or university if not ELHT, UCLAN or Lancaster University

Contract *

Permanent Temporary or Placement (please provide finish date)

Finish Date *

Please specify finish date if not a permanent contract

Home Address *

Work Phone Number *

Mobile Number - by giving us your mobile number you consent to receive library notifications by text message *

Do you already have an OpenAthens account? *

Yes No Not sure

OpenAthens username if known *

How did you hear about us? *

Further Information
For further information on what information we store, how your information is used, who we share it with, and your rights to access it, please read our privacy policy

Your Declaration *

Yes

I agree for membership of the Library Service and agree to abide by the terms and conditions. I agree to my data being held as described above.

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Learning Centre Library
Royal Blackburn Teaching Hospital
01254 734312 or Ext 84312
Find us

Mackenzie Library
Burnley General Teaching Hospital
01282 803114 or Ext. 13114
Find us

Staffed Opening Hours
Mon 08:30-16:30
Tue    08:30-16:30
Wed    08:30-16:30
Thu   08:30-16:30
Fri 08:30-16:00

24/7 access to both libraries is available - please see library staff

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