Mail the complete form (don’t forget to include your check or credit card info) to:
Louisiana Library Association—8550 United Plaza Boulevard, Suite 1001—Baton Rouge, LA 70809
Toll Free Phone: (877) 550-7890 . Fax with credit card information to (225) 408-4422 . Email: [email protected]
Name ________________________________________________________
Home phone ________________________________________________
Mailing Address _______________________________________________
Work phone _________________________________________________
Mailing City, State, and Zip _______________________________________
Billing Address ________________________________________________
Billing City, State, and Zip ________________________________________
Please check here if you do NOT want to be included in the online or printed directory.
Please check here if you do NOT want to be included in the LLA List Serve
1.
Email _____________________________________________
Job Title ____________________________________________________
Institution __________________________________________
Institution Parish _____________________________________
Please double check the e-mail address and area codes you enter in the form
2. Select your Sections below (additional Sections are $5 each):
Indicate Your Membership Type (see dues table below)
_____
Work Fax __________________________________________
INDIVIDUAL
Includes your choice of two Sections and two Interest Groups. New
Member Librarian (& non-member for 4+ years) 1st year dues are ½ price
set below.
_____ ACADEMIC
_____ LaSSAL
_____ GODORT
_____ PUBLIC
_____ TRUSTEES
_____ LASL
_____ SUBJ. SPECIALISTS
(2) Total amount for Sections $ _________
_____
RETIRED / FRIEND / STUDENT
Must pay for all Sections ($5) & Interest Groups ($3)
_____
CONTRIBUTING
Includes all Sections and choice of two Interest Groups
3. Select your INTEREST GROUP below (additional IG are $3 ea):
_____
TRUSTEE—includes automatic Section of Trustees and your choice of
one Section and two Interest Groups
_____ Children’s Services / Programming
_____
INSTITUTIONAL— Includes your choice of one Section and one Interest
Group and the membership of one library director or dean, as applicable.
_____ Automation & Technology
_____ BUSINESS INDIVIDUAL (FOR PROFIT)—non-voting membership.
Includes 1 vendor representative and 1 business card ad in LA Libraries.
_____ BUSINESS (FOR PROFIT)—non-voting membership. Includes 1
Individual representative, one 1/4 page ad in LA Libraries and one label
set.
_____
BUSINESS NON-PROFIT—non-voting membership. Includes 1 business
card ad in LA Libraries or 1 label set.
Membership Dues Table for 2016 — 2017
15.00
35.00
35.00
45.00
+ Sections & Interest Groups are not
included but may be added at an additional
charge.
*3 year limit as a student member
**Friends membership is open to anyone
not employed in libraries or the library
profession or eligible under any other
membership category
Salary: < $20,000
$20,000—29,999
$30,000—39,999
$40,000—49,999
$50,000—59,999
$60,000—99,999
> $100,000
35.00
50.00
65.00
85.00
95.00
120.00
135.00
Contributing
135.00
Institutional (Library)
Total Operating Budget:
Up to $100,000
Up to $200,000
Up to $500,000
Up to $1,000,000
Up to $2,000,000
Up to $3,000,000
> $3,000,000
_____ Diversity
_____ Library Managers
_____ Library User Education
_____ Outreach Services / Bookmobile
(3)
Total amount for
Interest Groups
$
____________
_____ New Member Round Table
_____ Preservation
_____ Reference
Individual Memberships
Lib. Science Student+*
Friend +**
Retired+
Trustee+
_____ Distance Education
150.00
200.00
250.00
300.00
350.00
425.00
500.00
Businesses
(Individuals/Partnerships/Corporations)
and Associations/Organizations
For profit:
Individual
85.00
Businesses 250.00
Non-Profit:
Organization 85.00
_____ Storytelling
_____ Teachers of Library Science
_____ Technical Services
_____ Teen Services
_____ Social Media
4. You may donate to a FUND
$__________ LLA Scholarship Fund
$__________Trustees’ Scholarship Fund
$__________Ollie H. Burns Minority Scholarship
(4)
Total amount for
Donations
$
____________
$________Disaster Relief Fund
TOTAL FROM BOXES 1, 2, 3, 4 $
Membership year runs from July 1 through June 30
_______________
(1) Membership Dues
$ ____________
Dues for any individual, library, business or non-profit association/organization joining after annual
conference are half of the designated annual dues.
All memberships include one copy of LLA’s publication Louisiana Libraries.
The Louisiana Library Association (LLA) is a nonprofit organization recognized as exempt from
federal income tax under section 501(c)(3) of the Internal Revenue Service Code. The LLA has
concluded that Individual (non-business) membership dues payments are deductible as charitable
contributions for federal income tax purposes. Contributions or gifts to LLA for which no goods or
services are received are deductible as charitable contributions for federal income tax purposes.
$25 of dues goes to members’ cost of a subscription to Louisiana Libraries.
Make Checks / Money Orders Payable to Louisiana Library Association
8550 United Plaza Boulevard, Suite 1001 Baton Rouge, LA 70809
or Fax with credit card information to (225) 408-4422
CREDIT CARD INFORMATION
O Mastercard O VISA O AMEX O DISC
Credit Card Number ___________________________________________________
Expiration Date _____________ Name on Card _____________________________
Address on Card _____________________________________________________
Your Signature _____________________________ CVV _____________________