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2021 Membership Form
Membership year is concurrent with the calendar year (January 1 through December 31).
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Title
*
Your answer
Institution/Library Name
*
Your answer
Mailing Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip code
*
Your answer
Phone
*
Your answer
Email address
*
Your answer
Committee Interest (Multiple boxes can be checked.)
*
Continuing Education
Membership
Nominating
Outreach
Program planning
Scholarship
Strategic Planning
Website design and administration
Currently not interested
Required
Please put in order your 1st, 2nd, & 3rd preferences for committee involvement.
Your answer
Interest in serving as a GHSLA officer?
*
Yes
No
Other membership affiliations:
*
MLA
SC/MLA
GLA
SLA
ALA
Other:
Required
Payment Methods
*
via Check: Payable to: GHSLA (FID#35-2186668); mail form + check to: Emily Lawson, GHSLA Treasurer, Emory University, Woodruff Health Sciences Center Library, 1462 Clifton Rd NE. Atlanta, GA 30322
PayPal: Total of $21 (includes $1.00 processing fee; available at
http://ghsla.org/membership/
)
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