Texas Library Association
MAIL TO: 3355 Bee Cave Road, Suite 401 • Austin, TX 78746-6763
512/328-1518 • 800/580-2852 • FAX: 512/328-8852 • Email: [email protected]
www.txla.org • INDIVIDUAL MEMBERSHIP •
SECTION I — DIRECTORY INFORMATION
CALENDAR YEAR 2010 JAN-DEC
Dues must be postmarked by February 1, 2010 to vote for association officers.
New member? You are encouraged to join the New Members Round Table in
addition to Round Tables or Interest Groups in your specialized area.
Members falling into two or more categories of membership shall pay the highest
applicable dues. Individual membership dues are non-refundable and nontransferable.
Except for $2.77 of your dues for this year’s subscription to the Texas Library
Journal and TLACast, your TLA dues are tax deductible as a charitable donation.
A printed TLA Membership Directory will be available July 2010.
FIRST TIME MEMBER?
____________________________________________________________ FIRST NAME
_________
INITIAL
PREFERRED Mailing Address:
________________________________________________________________
LAST NAME HOME
WORK
____________________________________
nickname (if any)
________________________________________________________________________________________________ ___________________________________________________________________________________
EMPLOYMENT: Institution/System/Library
Campus/Branch/Department
________________________________________________________________________________________________ _____________________________________ ______________ ______________________________
BUSINESS ADDRESS
CITY
STATE
ZIP + 4
________________________________________________________________________________________________ _____________________________________ ______________ ______________________________
HOME ADDRESS
CITY
STATE
ZIP + 4
(__________) __________ – __________________ | (__________) __________ – __________________ | (__________) __________ – __________________ | (__________) __________ – __________________
WORK PHONE
FAX
HOME PHONE CELL PHONE
___________________________________________________________________________________________ _______________________________________________________________________________________
preferred EMAIL SECONDARY EMAIL
Useful and timely information is provided via electronic discussion lists, emails, and publications from TLA and occasionally from screened outside organizations.
Please indicate YOUR preferReD Source of information:
From TLA and outside organizations -orFrom TLA only.
Do not publish my home information.
I do NOT want to be automatically subscribed to Unit electronic distribution lists.
SECTION II — MEMBER CATEGORY
Personal Member
DUES SCHEDULE
(Librarian, Library Professional, Library Staff)
•
•
•
•
•
•
•
•
Unemployed through $9,999.................. $25.00
Salary $10,000 through $14,999............ $40.00
Salary $15,000 through $19,999............ $50.00
Salary $20,000 through $29,999............ $65.00
Salary $30,000 through $39,999............ $90.00
Salary $40,000 through $59,999.......... $125.00
Salary $60,000 through $79,999.......... $135.00
Salary $80,000 and above.................... $150.00
Out of State Member.............................$30.00
Full-time Library Student.......................$25.00
Retired Librarian...................................$30.00
Trustee/Layperson/Vendor/Advocate.....$30.00
Supporting Member............................$200.00
SECTION V — PAYMENT
DUES
BASIC DUES
Includes one Division and one
Round Table / Interest Group............ $_ __________
Each Additional Division at
10% x Basic Dues = ......................... $ ___________
Each Additional Round Table or
Interest Group at 5% x Basic Dues =.$ ___________
Membership Directory at
$25.00 each = .................................. $ ___________
Professional Liability Insurance
$35.00 Annually (Jan-Dec)................ $ ___________
installment plan
available through
online renewal or
enrollment.
SECTION III — DIVISION
(One Division included in Basic Dues)
College and University Libraries
Public Libraries
Special Libraries
Texas Association of School Librarians
No Preference
See txla.org for disclosure information.
TOTAL PAYMENT ........................... $_ __________
RETURN ENTIRE FORM WITH PAYMENT
NO PURCHASE ORDERS ACCEPTED
SECTION IV — ROUND TABLE (RT) OR INTEREST GROUP (IG)
(One Round Table or Interest Group included in Basic Dues)
Acquisitions & Collection Development RT (A)
Interlibrary Loan & Resource Sharing RT
Archives & Local History RT (B)
Library Friends, Trustees & Advocates RT
Automation & Technology RT (N)
Library Instruction RT (U)
Black Caucus RT (Z)
Library Services to Spanish Speaking RT
Cataloging & Metadata RT (C)
Library Support Staff RT (X)
CE Providers IG (Aa)
Media & Related Technologies RT (P)
Children’s RT (D)
New Members RT (J)
Digital Libraries RT (Dd)
Programming for Adults IG (Kk)
Disability & Aged Issues IG (Hh)
Reference RT (F)
Distributed/E-Learning IG (Jj)
Small Community Libraries RT (Q)
Doo-Wop Intergalactic RT (Bb)
SMART (Administration) RT (M)
E-SMART (Serials) RT (R)
Storytelling RT (W)
Friends of School Libraries RT (Ff)
TALL Texans RT (Y)
Gay, Lesbian, Bisexual, Transgendered IG (Cc)
TPALS RT (S)
Genealogy RT (Gg)
Young Adult RT (H)
Government Documents RT (K)
No Preference
Check or Money Order payable to:
TEXAS LIBRARY ASSOCIATION
(L)
(G)
(T)
VISA AMERICAN EXPRESS MASTERCARD
DISCOVER
Card # _______ /_______ /_______ /_______
Expiration Date: ______ /_______
Cardholder
Signature: ______________________________
FOR OFFICE USE ONLY
Rec_ ______________________________________
Ck#_ ______________________________________
Amt_ ______________________________________