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    • PLA Leadership Fellows Application for Columbia

    PLA Leadership Fellows Program - Application to Columbia

    Personal Information

    Prefix* Other Prefix
    First Name*
    Middle Name
    Last Name*
    Nick Name
    Date of Birth*
    Title*
    Name of Library*
    Library Street Address*
    Library Street Address 2
    City*
    Country* USA Canada Other Countries
    State*
    Zip*
    Work Telephone*
    Work Fax
    Work Email*
    Home Street Address*
    Home Street Address 2
    City*
    State*
    Zip*
    Home Telephone
    Home Fax
    Home (Other) Email

    Education Information

    Colleges, Graduate/Professional Schools Attended (most recent first)
    Name Location Degree/Major
    Attended From To Date Degree Conferred
    Name Location Degree/Major
    Attended From To Date Degree Conferred
    Name Location Degree/Major
    Attended From To Date Degree Conferred

    Admission Requirements

    An organization chart that includes your position
    I will mail or fax a copy of my library's organizational chart which includes my position as part of my application.

    Your resume
    I will mail or fax a copy to complete my application

    A written statement describing your major responsibilities, challenges, and expectations of the INM program. The statement should include a list of measurable outcomes that you are responsible for achieving as part of your responsibilities.


    A description of your library: size, community served, etc.

    Leadership Fellows Scholarship Requirements

    Number of years in a management role at your library

    Please describe your major responsibilities at your library (75 words or less)


    What are the specific challenges facing your library and/or a major project or initiative you may be leading in your organization (75 words or less)


    If selected, I agree to the providing a written report on my experience in this program.

    If selected, I would have the support of my institution for time to attend. I also understand that the fellows program covers cost of the program, housing and most meals. Travel costs and arrangements are not covered in the award.



    Mailed or faxed application materials should be submitted to:

    Public Library Association
    50 E. Huron St.
    Chicago, IL 60611
    ATTN: Leadership Fellows Program

    Fax: 312-280-5029
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