The "Access PA" sticker just means that your library is participating member of the "Access PA" system.
Think of it as a larger "inter-library" lending program.
I went to
http://libwww.freelibrary.org/register/getcard1.cfm and filled out the online form. You have to do that any way. Even if you want to pay $15.
If you want to make a donation go to
http://www.freelibrary.org/donate/donate.htm
The first time that you want to take out
physical material (books, audiobooks, etc) you have to show ID just like you did for your first library card.
But as you already have a card from a participating PA library they will mail you a card for
their library.
As I understand it - at that point you can go online to download e-books and audiobooks.
I've downloaded audiobooks from my local Bucks county with no problems at all. I filled out pretty much the same form both times.
What I do not know is if I need to get a card from each Library system that I want to use. I think so though.