ANCHASL Continuing Education Award
Application Form
ANCHASL 2018 Spring Meeting and CE Course
“BuildingPartnerships with Faculty, Clinicians and Other Stakeholders.”
UNC-Charlotte J. Murrey Atkins Library, Charlotte, NC
April 13, 2018
Deadline for submitting this application isend of day (midnight) Monday, March 12, 2018
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Are you currently a member of ANCHASL? Yes ____Joining now____
Membership is required for the Award; however, if you are not currently a member, you may join now. ANCHASL membership information and an online application linkare available here:
Are you currently residing in NC, employed by a library or information services organization located in NC, or enrolled in a library program located in NC? Yes____ No (stop now)
You must live, work, or study in NC to be eligible for this award.
Scholarships are limited to one scholarship per applicant per calendar year. Current ANCHASL Board members and Scholarship Committee members are not eligible to receive scholarship awards.Note: past ANCHASL Board members are eligible, but must have completed their term of office prior to the date of the meeting—i.e., prior to April 13, 2018.
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Applicants whose place of residence is within 90 miles of the venue will be eligible to receive awards of up to $75, whileapplicants whose place of residence is further than 90 miles from the venue may receive awards up to $175.Awards will be mailed to recipients prior to the SpringMeeting. Failure to attend the meeting for any reason will require reimbursement of the award to ANCHASL.
Following the 2018 Spring Meeting, winners will submit a brief report on their experiences, which will be presented at the ANCHASL 2018Fall Meeting via the Scholarship Committee Chair’s report to the Board. A reporting form will be provided to recipients.
Part 1: Meeting/CE Course
This award will support an ANCHASL member attending the ANCHASL 2018 Spring Meeting and CE Course: “Building Partnerships with Faculty, Clinicians and Other Stakeholders,” at UNC-Charlotte’s J. Murrey Atkins Library in Charlotte, NC on April 13, 2018.
What are your estimated total expenses for attending theSpringMeeting? Estimates may include registration, CE fees, meals, lodging, and transportation.
What is the distance (one way, in miles) that you will be traveling to attend the meeting?
Part 2: Applicant Contact Information
Name
Institution
Address
Address (Line 2)
City
State
Zip
Telephone
Part 3: Experience
If employed, please describe your currentposition.
InstitutionDates (Month/Year) Job Title
Part 4: Education (for student applicants)
If a student, please provide the following details about your current program of study.
School Field of StudyDegree PursuedExpected Date of Graduation
Part 5: Benefits of Attending
Please provide a brief (no more than one or two paragraphs) statement explaining how you would expect to benefit from receiving an ANCHASL Continuing Education Award.
Part 6: Agreement
“The information I have supplied on this application is true and correct to the best of my knowledge. I understand that any misrepresentation may cause denial or withdrawal of the award. I also acknowledge that ANCHASL may use my name and/or photo for publicity in relation to this award. I understand that failure to attend the meeting will require me to return the award to ANCHASL.”
Signature:
Date:
Please email your completed application toAlex Carroll, ANCHASL Scholarship Committee Chair, questions related to the scholarship application may also be directed to the Scholarship Committee Chair.
Applications must be received no later than end of day (midnight),Monday, March 12, 2018.
Winners will be notified byMonday, March 19, 2018.