Library Board Membership

An online form to collect library board member information.

• List up to 5 trustees who are members of the library board as of August 1, 2008.  
  
• Enter additional board members on the Library Board Member, Additional and Updated form.
  
• Indicate new board members with an *.
  
• As changes occur, please notify the State Library and the Library Service Area.
• Be sure to complete the information on the number of board meetings scheduled and workshops/conferences attended. This information is for the period of July 1, 2007-June 30, 2008, and is not applicable to new Board Members.
• NOTE: PLEASE GIVE COMPLETE MAILING ADDRESS OF YOUR BOARD MEMBERS.
  

City of Library (Required)

Locator Code (Required)

Number of Meetings Scheduled (Required)

Number of Board meetings scheduled in the past year.

Trustee Name 1 (President/Chair) (Required)

President/Chair

Trustee Address 1 (Required)

Mailing address

City of Trustee 1 (Required)

City in which the trustee resides

Zip Code of Trustee 1 (Required)

Zip Code of the city in which Trustee 1 resides

Term Expires, Trustee 1 (Required)

Mo/Day/Yr

Workshops Attended, Trustee 1

No. of Professional Conferences/Workshops Attended

E-mail Address of Trustee 1

Notes, Trustee 1

Name of trustee this person replaces, if applicable.

Trustee Name 2 (Required)

Trustee Address 2 (Required)

Mailing address

City of Trustee 2 (Required)

City in which the trustee resides

Zip Code of Trustee 2 (Required)

Zip Code of the city in which Trustee 2 resides

Term Expires, Trustee 2 (Required)

Mo/Day/Yr

Workshops Attended, Trustee 2

No. of Professional Conferences/Workshops Attended

E-mail Address of Trustee 2

Notes, Trustee 2

Name of trustee this person replaces, if applicable.

Trustee Name 3 (Required)

Trustee Address 3 (Required)

Mailing address

City of Trustee 3 (Required)

City in which the trustee resides

Zip Code of Trustee 3 (Required)

Zip Code of the city in which Trustee 3 resides

Term Expires, Trustee 3 (Required)

Mo/Day/Yr

Workshops Attended, Trustee 3

No. of Professional Conferences/Workshops Attended

E-mail Address of Trustee 3

Notes, Trustee 3

Name of trustee this person replaces, if applicable.

Trustee Name 4 (Required)

Trustee Address 4 (Required)

Mailing address

City of Trustee 4 (Required)

City in which the trustee resides

Zip Code of Trustee 4 (Required)

Zip Code of the city in which Trustee 4 resides

Term Expires, Trustee 4 (Required)

Mo/Day/Yr

Workshops Attended, Trustee 4

No. of Professional Conferences/Workshops Attended

E-mail Address of Trustee 4

Notes, Trustee 4

Name of trustee this person replaces, if applicable.

Trustee Name 5 (Required)

Trustee Address 5 (Required)

Mailing address

City of Trustee 5 (Required)

City in which the trustee resides

Zip Code of Trustee 5 (Required)

Zip Code of the city in which Trustee 5 resides

Term Expires, Trustee 5 (Required)

Mo/Day/Yr

Workshops Attended, Trustee 5

No. of Professional Conferences/Workshops Attended

E-mail Address of Trustee 5

Notes, Trustee 5

Name of trustee this person replaces, if applicable.

Date (Required)

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Your e-mail address (Required)