OLSSI Planning Committee Membership Form

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* 1. Date:

Date / Time

Date

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* 2. Name

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* 3. Library

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* 4. Address

Library

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 5. Why would you like to join the OLSSI Planning Committee

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* 6. What skills or experience would you bring to the planning committee (no experience necessary)

Thank you. Your application will be reviewed by the committee and you will be notified after the next regularly scheduled meeting.