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NYLA Developing Leaders Program: 2021-2022 Cohort – Participant Application

Please use this form to submit your application to participate in the NYLA Developing Leaders Program 2021-2021.

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* 1. Applicant Contact Information

Name *

Company or Library *

Address

City/Town *

State/Province

ZIP/Postal Code

Email Address *

Phone Number

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* 2. How many years of experience do you have working in libraries?

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* 3. Library 'segment' represented:

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* 4. Primary section affiliation:

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* 5. Do you have an MLS? (MLS is NOT required for participation.)

Yes

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* 6. Please sort the ALA core values in order of how they resonate with you and your work as a librarian. This will be used in assigning you to a working group.

Access

Confidentiality/Privacy

Democracy

Diversity

Education and Lifelong Learning

Intellectual Freedom

The Public Good

Preservation

Professionalism

Service

Social Responsibility

Sustainability

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* 7. What do you hope to gain from your participation in the Developing Leaders Program?

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* 8. Other Comments, Thoughts, Ideas, Suggestions?

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* 9. I have the endorsement of my employer to participate in this program, including the necessary release time (46.5 hours) for programs and projects:

Yes

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* 10. My tuition and any other related expenses are being covered by:

My employer

Me personally

A combination

Grant funds

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* 11. Please consider me for available scholarships:

Yes

I do not require scholarship support, please reserve it for others.

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* 12. If accepted into the program, I agree to attend all program offerings, and participate fully in the program activities and team project.

I agree.

Thank you for your application! Remember to have a letter of recommendation submitted.