NCLwinter.04


246 — Winter  2004                                                                                                                                                       North Carolina Libraries

Use the application form below to enroll as a member of the North Carolina Library Asssociation or to renew
your membership. All memberships are for one year from the anniversay date of first payment.

Dues (see below) entitle you to membership in the Association and to one section or round table. For each
additional section or round table, add $5.00. Return this form with your check or money order, payable to
North Carolina Library Association (see address below).

NCLA
North Carolina Library Association

NCLA
North Carolina Library Association

Mail Payment and Form to:
North Carolina Library Association
4646 Mail Service Center
Raleigh, NC 27699-4646

CHECK SECTIONS AND ROUND TABLES

ONE IS INCLUDED IN BASIC DUES. (New Members & First Time

Renewals should choose a section other than New Members Round Table.)

Add $5.00 for each additional section or round table.

___ Children’s Services

___ College & University Section

___ Community & Junior College Libraries Section

___ Documents Section

___ Library Administration & Management

___ Circulation SIG

___ Personnel/Staff Development SIG

___ NC Association of School Librarians

___ NC Public Library Trustees Association

___ Public Library Section

___ Reference & Adult Services Section

___ Resources and Technical Services Section

___ New Members Round Table

___ NC Library Paraprofessional Association

___ Round Table for Ethnic Minority Concerns

___ Round Table on Special Collections

___ Round Table on the Status of Women in Librarianship

___ Technology & Trends Round Table

THANK YOU FOR YOUR SUPPORT
NCLA Office Hours: Mon.–Fri. 9–1; Telephone:  919-839-NCLA; FAX: 919-839-6253; e-mail: nclaonline@ibiblio.org

TYPE OF LIBRARY I WORK IN: Academic _____ Public _____ School _____ Special _____ Other ____________________________

Please print or type Date Submitted ____________________

______ New membership*  ______ Renewal* Membership Number if Renewal _____________________________________
* Dues automatically include membership in New Members Round Table for NEW MEMBERS and for FIRST TIME renewals.

Name ____________________________________________________________________________________________________________
                                    Last                                       First                                     Middle

Title _______________________________________________   Library __________________________________________________

Business Address _________________________________________________________________________________________________
                                                                                                             City                              State             Zip

Mailing Address (if different from above) ___________________________________________________________________________

Daytime Telephone Number _____________________________ E-mail address ___________________________________________

❏ Check here if you DO NOT wish to be signed up for NCLA-L listserv

Area Code

❏ FULL-TIME LIBRARY SCHOOL STUDENTS
(two years only) ............................................. $10

❏ RETIRED LIBRARIANS ................................... $15

❏ NON-LIBRARY PERSONNEL:
(Trustee, Volunteer, or Friends of Libraries) .. $15

❏ INSTITUTIONAL (Libraries or
Library/Education-related Businesses) ........... $50

CHOOSE YOUR CATEGORY OF MEMBERSHIP

❏ LIBRARY PERSONNEL
Earning up to $15,000 ................................... $15
Earning $15,001 to $25,000 .......................... $25
Earning $25,001 to $35,000 .......................... $30
Earning $35,001 to $45,000 .......................... $35
Earning $45,001 and above ........................... $40

❏ CONTRIBUTING (Individuals, institutions,
and businesses interested in the work
of NCLA) ..................................................... $100
AMOUNT ENCLOSED: (SEE ABOVE)

$ ____________  Membership and one section/round table

   ____________  $5.00 for each additional section/round table

$ ____________  TOTAL (PLEASE DO NOT SEND CASH)

Credit Card Info (VISA or MasterCard)

#_______________________________________ Exp. ___________



North Carolina Libraries                                                                                                                                               Winter  2004 — 247

Make check payable to NCLA and write “Endowment” in the FOR line.

Send form with contribution to: NCLA Administrative Assistant
NCLA Endowment
4646 Mail Service Center
Raleigh, NC 27699-4646

The North Carolina Library
Association established the
NCLA Endowment Fund with
the North Carolina Community
Foundation in 1999. The
purpose of the Endowment is to
support the NCLA Scholarship
Fund for library school students,
to provide funding for out-

standing speakers at the NCLA Biennial Conference, and to
enhance continuing education of North Carolina librarians.

For more information
call NCLA at (919) 839-6252

SPECIAL GIFTS AND REQUESTS:

❑ Sustainer @ $100–$249
❑ Friend @ $1–$99
❑ Other @ $ ____________

❑ Corporate @ $ ______________
❑ Company Name
❑ In Memory ❑ In Honor of:

Acknowledgement to be sent to (name and address):

❑ Donation of stock, real estate, etc., or bequest. Check here for further
information, or contact the NCLA Administrative Assistant at the
address below.

I want to contribute to the NCLA Endowment.Ye
s!

Name(s)

Address

Telephone                                 e-mail

Type of contribution:

❑ Benefactor @ $1,000 Up
❑ Sponsor @ $500–$999
❑ Patron @ $250–$499

N C L A  E n d o w m e n t
Affiliate Fund of the North Carolina Community Foundation

N LAC
No r t h  C a r o l i n a  L i b r a r y  A s s o c i a t i o n