NCLsummer.03 North Carolina Libraries Summer 2003 — 87 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 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. ___________ 88 — Summer 2003 North Carolina Libraries 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 ow 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