Routledge Distance Learning Librarianship Conference Sponsorship Award
Nomination Form
Nomination/Application for 2013 (Due December 7, 2012).
This award is administrated by the ACRL Distance Learning Section (DLS).
NAME OF NOMINEE ____________________________________________
Home address ________________________________________________
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Home phone __________________________________________________
Work address _________________________________________________
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Work phone ___________________________________________________
Work FAX _____________________________________________________
Email address: _________________________________________________
EDUCATION
Degree Institution Date(s)
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LIBRARY AND OTHER RELATED POSITIONS:
Employer Position Date(s)
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Service to ALA (ACRL, DLS, as well as other related sections and divisions) and related professional organizations:
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Contributions to distance learning library services:
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Research and publication contributing to distance learning library service:
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Nominated by:
Name ______________________________________________
Home address: ______________________________________
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Home phone: _______________________________________
Work address: ______________________________________
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Work phone: ________________________________________
Work FAX: __________________________________________
Email address: _______________________________________
Please return 1 copy of this complete application/nomination form and all supporting material (letters of support, etc.) to the Chair of the Award Committee:
Mou Chakraborty
Director of Public Services
Salisbury University
T: (410) 543-6131
E-mail: mxchakraborty@salisbury.edu
