Please indicate if you are a student, unemployed or retired.
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Institutional Affiliation
(If Applicable)
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Phone Number: *
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Email Address: *
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How far along are you in your career? *
What types of libraries have you worked in? *
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Please provide a brief description of your career experience. *
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Please provide a description of your leadership experience. *
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Briefly, how do you hope to benefit from this program? *
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Please confirm, by typing your name below, that you understand that this program requires your conference attendance on Monday, February 6, 2017 from 8:00am - 12:00pm in New Orleans. *