Sustainability Committee Interest Form

Please fill out the following interest form by March 21, 2021:

President Jefferson and President-elect Wong will jointly appoint the seven members, which will include a Chair, to begin immediately. Four (4) Members will have terms through June 2023. Three (3) members will have terms through June 2022.

*1.Please enter information below:(Required.)

Name

Organization

Title

City/Town

State/Province

Email Address

2.Member Years

*3.Current Memberships (Divisions, Roundtables, Chapters, Affiliates, etc):(Required.)

*4.Why are you interested in serving on this committee?(Required.)

5.List any education and experience you would like to share:

6.List an ALA, Division, or Roundtable appointments or offices currently held:

7.List any other pertinent information you would like to share:

8.Please indicate if you are a current or past:

Emerging Leader

Spectrum Scholar

9.Are you interested in serving as (check all that apply):

Committee Chair (through June 2022)

One-year term (through June 2022)

Two-year term (through June 2023)

10.With which gender identity do you most identify?

11.Do you identify as a person with a disability or disabilities?

Yes

Prefer not to state

If you selected that you have a disability, please describe (optional):

12.Race:

American Indian/Alaska Native

Asian

Black/African American

Hispanic/Latino

Middle Eastern and North African

Native Hawaiian/Other Pacific Islander

White

Self Identify

Prefer not to answer

13.Are you a member of any of the following affiliates:

American Indian Library Association

Asian Pacific American Librarians Associations

Black Caucus of the American Library Association

Chinese American Librarians Association

REFORMA (National Association to Promote Library & Information Services to Latinos and the Spanish Speaking)

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