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Teacher/Program Application

Address Block

Please enter all information in upper/lower case.

Your information will not be saved until you have completed all the required information on this page and the next page.  If you would like to exit now and complete your application at a later date, please use place holder information (for example, "n/a") for the remaining questions and hit "Save & Edit Later" at the end of this form.  You will be able to make changes to your submission through 11:59 p.m. Central time, Friday, December 6, 2013.

First Name*
Last Name*
Title
Email*
Work Phone*
Phone Ext
Institution*
Address*
Address
City*
State*
Zip Code*
Country*
Are you applying for the Program Track or Teacher Track? [REQUIRED]
Program Track
Teacher Track
Type of Institution [REQUIRED]
University
Liberal Arts College
Community College
Other
How many years have you been involved with library instruction? [REQUIRED]

How many years have you worked in an academic library? [REQUIRED]

If I am accepted, I have financial support from my institution to attend. [REQUIRED]
Yes
No
Work Experience [REQUIRED]

List jobs, dates, and primary responsibilities.


Education [REQUIRED]

List institutions, degrees completed, and dates:


Professional presentations and publications [REQUIRED]

Your information will not be saved until you have completed all the required information on this page and the next page. If you would like to exit now and complete your application at a later date, please use place holder information (for example, n/a) for the remaining questions and hit "Save & Edit Later" at the end of this form. You will be able to make changes to your submission through 11:59 p.m. Central time, Friday, December 6, 2013.

Press the "Continue" button below.