Florida Department of State

Division of Library and Information Services

(an * means this field is required)

First Name *
Last Name *
Telephone Number *
Email *
Please note that under Florida law, e-mail addresses are public records. You must provide an email address for the organization to apply. The email address that you supply will be public record.
Confirm Email *
Organization *
If Other, please Specifiy
Password (5-20 characters) *
Case-sensitive. Spaces are not allowed.
Confirm Password *