NMLD Board Application

Please print, complete information below, and return to:

Nominating Committee, c/o NMLD Office, 145 Harlow St, Bangor, Maine 04401

Name (Mr.  Mrs.  Ms.)  ______________________________________________

Employment _____________________________________________________

Title _____________________________________

Mailing Address __________________________________________________

Daytime Phone ___________________Evening Phone ___________________

Email __________________________________________________________

Previous Position ________________________________________________

Resume Enclosed         Yes ____               No ____

Name of Library _________________________________________________

Education ______________________________________________________

Library School ___________________________________________________

Library Affiliations and Memberships

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______________________________________________________________

Other Information of Interest (publications, awards, etc.)

______________________________________________________________

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I want to serve on the NMLD board because…

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