PSLA Member-at-Large Interest Form

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This form will be used to select a Member-at-Large representative to serve on the Nominations Task Group. Selection will be made according to the methods outlined in the

First and Last Name *

Preferred Phone Number *

Preferred Email *

Choose your Membership Level *

Active Membership

Association Membership

Honorary Membership

Are you involved in a PSLA Committee?

Yes

Clear selection

What PSLA Committee?

Advocacy

Awards

Communications

Conference

Operations

Teaching and Learning

Clear selection

Are you involved in a PSLA Affiliate?

Yes

Clear selection

What PSLA Affiliate?

Beaver County Association of School Librarians (BCASL)

East Central Pennsylvania School Librarians Association (ECPSA)

South Central Pennsylvania School Librarians Association (SCPSLA)

Western Pennsylvania School Librarians Association (WPSLA)

Westmoreland County Association of School Librarians (WCASL)

Clear selection

Do you agree to: 1. Abide by the PSLA’s Constitution, Bylaws and committee policies; 2. To sign the Conflict of Interest Policy, and; 3. To participate in all Nominations Task Group Meetings? *

Yes

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