NDLA Membership Form

Membership for the Year Ending December 31, 2012

Name:
Address:
City State Zip+4:
Institution:
Position:
Work Phone:
Home Phone:
FAX:
E-mail (Required field):
	Individual e-mail address required for participation in elections and electronic discussion. NDLA does not distribute e-mail addresses outside the Association.
Sections/Roundtables - - membership entitles you to join as many as you wish!
Academic and Special Libraries Section Health Science Information Section Public Library Section School Library & Youth Services Section Archives/Records Management Roundtable Government Documents Roundtable New Members Roundtable Technical Services Roundtable

$	Personal Membership Dues
	$35.00	Individual
	$20.00	Student (for persons enrolled in a library school program (3-year limit))
	$20.00	Trustee (for library board members)
	$20.00	Associate (non-voting membership for persons not employed in a North Dakota Library (friends, retirees, etc.))

$	Institutional Membership Dues (does not include personal memberships)
	$50.00	Libraries with up to 3 FTE staff (one person from library's staff may register at conference member rate)
	$100.00	Libraries with 4-9 FTE staff (two persons from librar's staff may reegister at conference member rate)
	$150.00	Libraries with 10 or more FTE staff (three persons from library's staff may register at conference member rate)

IMPORTANT: After clicking the send button below you will be redirected to a Thank You screen. Look for a link that says "Click here to pay membership fees via Paypal. You MUST click on one of the links to use Paypal to process your membership fees.