Emerging Leaders - Application Form

First Name (Required)

Middle Name

Last Name (Required)

Street

City

State

Zip

Country:

Local Phone (Required):

E-Mail (Required):

Gender: Female Male

American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
Hispanic/Latino
White
Other race or family origin Please specify:
Two or more

If you have a MLS/MLIS, please select where you received it:
None Alabama, University of Albany, State University of New York Alberta, University of Arizona, University of British Columbia, University of Buffalo, State University of New York California - Los Angeles, University of Catholic University of America Clarion University of Pennsylvania Dalhousie University Denver, University of Dominican University Drexel University Emporia State University Florida State University Hawaii, University of Illinois, University of Indiana University Iowa, University of Kent State University Kentucky, University of Long Island University Louisiana State University McGill University Maryland, University of Michigan, University of Missouri-Columbia, University of Montreal, University of North Carolina - Chapel Hill, University of North Carolina - Greensboro, University of North Carolina Central University North Texas, University of Oklahoma, University of Pittsburgh, University of Pratt Institute Puerto Rico, University of Queens College, City University of New York Rhode Island, University of Rutgers University St. Catherine University St. John's University San Jose State University Simmons College South Carolina, University of South Florida, University of Southern Connecticut State University Southern Mississippi, University of Syracuse University Tennessee, University of Texas - Austin, University of Texas Woman's University Toronto, University of Valdosta State University Washington, University of Wayne State University Western Ontario, University of Wisconsin - Madison, University of Wisconsin - Milwaukee, University of

Are you under 35 years of age? (If not, you must be able to respond "Yes" to the next question)
Yes No

If you are 35 years of age or older, Are you a new library professional of any age with fewer than 5 years of experience working at a professional or paraprofessional level in a library?
Yes No

Are you able to attend both ALA conferences and work virtually in between the two conferences?
Yes No

Are you prepared to commit to serve on an ALA, Division, Chapter, or Round Table committee, taskforce or workgroup, or your state or local library organization upon completion of the Emerging Leaders program?
Yes No

List information for your current employer. Previous employers should be included on your resume. If you are currently unemployed, put Unemployed in the name field.

If you are currently employed, your employer should give consent for you to attend both of the ALA conferences and to participate in the program. Enter your supervisor's information below and they will be contacted for approval.

Please describe your leadership, community, civic, and volunteer experiences:

Please describe your philosophy of effective leadership:

ALA President-Elect Barbara Stripling’s statement of professional concerns included a statement about building diverse library leadership. How would you start this process in your local library community, on your job, or in your state library association?

How would you bring diversity to the next class of Emerging Leaders? You may consider any form of diversity:

How do you think participation in the Emerging Leaders program will affect your leadership abilities?

Reference Name (required):

Title of Position Held:

Employer Name, Address, City and State:

Phone Number (required):

Email (required):

Reference Name (required):

Title of Position Held:

Employer Name, Address, City and State:

Phone Number (required):

Email (required):