( ) I accept your invitation to serve as: _____Member ____Chair ___Other of the ALTA Committee _____________________
for a _____ year term (200__ - 200__). The term begins with the adjournment of the
200__ Annual Conference and expires with adjournment of the 200__ Annual Conference.
( ) I am unable to accept the appointment.
I certify that I am currently a member of the Association for Library Trustees and Advocates. My ALA membership number is:
_________________________________________________________.
Preferred Mailing Address: ( ) Business/Office ( ) Home ( ) Other (specify and please include phone)
Business/Office Address or Home Address/City/State/Zip
______________________________________________
______________________________________________
Phone: ( ___ ) ____-______
Home Phone: ( ___ ) ____-______
(Note: not the phone number of your library.)
Office Fax: ( ___ ) ____-______
Home Fax: ( ___ ) ____-______
E-mail: ________________________________________
Home E-mail: ___________________________________
I am a trustee at _____________________ Library.
Please review the following:
I am aware of ALA Policies 4.4 and 4.5 which state that no member shall serve concurrently in more than three ALTA or ALA positions, and that committee members are expected to attend the Midwinter Meeting and Annual Conference. I understand that failure to attend two meetings, without an explanation to the chair, constitutes grounds for removal.
Listed below are my current committee(s) and/or other assignment(s) in ALTA, ALA and other ALA units and the dates of my term(s):
____________________________________________________________________________________________
By accepting this appointment, I agree that all working papers and final products of the group are the sole property of ALTA and are not to be used for any personal projects unless written permission has been obtained from the appropriate governing body. I also certify that this committee assignment does not represent a conflict of interest.
Signature:_______________________________________
Date:_____________________________
Print Name:______________________________________
If you change position and/or address, during your term, please notify the ALTA office.
Please make a copy of this form for your files.