ACRL Scholarship Application
| ALA Membership No. |
Length of ACRL Membership: |
| Name of ACRL Event: |
| Name: |
| Current position title: |
Date started: |
| Institution: |
| Mailing Address: |
| City, State, Zip: |
| E-mail: |
Phone: |
| Your current salary: |
| Library Director’s Name: |
| MLS degree earned in (year): |
at (name of institution): |
Your ethnic background (check only one)
| _____ African American |
_____ Caucasian |
_____ Hispanic/Latino(a) |
| _____ Native American |
_____ Asian/Pacific Islander |
_____ Other (specify) |
Library Employment History
Please list below positions held prior to current position:
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Institution/Title
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From
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To
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Type of library currently employed by:
| _____ College Library |
_____ University Library |
| _____ Community & Junior College Library |
_____ Private Sector/For Profit University |
Amount of funding requested: $___________________________________________
| ______________________________________________________ |
_________________________________ |
| Signature of Library Director |
Date: |
I certify that the information that has been provided is correct. I understand that the Scholarship Committee will keep this information confidential.
| ______________________________________________________ |
_________________________________ |
| Signature |
Date: |
Unless otherwise specified by the particular ACRL scholarship you are applying for, send to:
ACRL Scholarships
50 East Huron Street
Chicago, IL 60611.
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