professornana (professornana) wrote,
professornana
professornana

application for Walden Committee

Amelia Elizabeth Walden Award Selection Committee
Self-Nomination Form
2012
DEADLINE: SEPTEMBER 15, 2011




Name:

Professional Role (please select one): Teacher University Professor Librarian

If you are a teacher, please indicate grade level(s) taught:

If you are a librarian, please indicate if you are public or school:

ALAN Member? Yes No If yes, please indicate number of years: _________

Institutional Affiliation:


E-mail Address:

Mailing Address:



Phone Number(s):

Statement describing why you wish to serve on the committee (please include previous experience on juried committees, experiences as a book reviewer, etc.):













Names and contact information for two references able to speak to your potential to work in this capacity:

Reference Name E-mail Address and Phone Number
1)

2)






Please send this application electronically to:


Ricki Ginsberg, Chair
2011-12 Walden Committee

rickiginsberg@gmail.com
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