NOMINEE INFORMATION: Nominee Library or Organization * :
Nominee Professional Title * :
Please select ... Adult/Public Library Services Librarian Assistant Library Director Cataloging Librarian Children’s Services Librarian Circulation/Access Services Librarian Collection Development/Acquisition Librarian Electronic Resources Librarian Emerging Technologies Librarian Head Librarian Library Director Library/Branch Manager LIS Student Outreach Librarian Paralibrarian/ Paraprofessional Readers Advisory Librarian Reference/Information Services Librarian School Library Media Specialist Teacher Librarian Technical Services/Systems Librarian YA/Teen Librarian Youth Services Librarian Curriculum Coordinator Reading/Literacy Specialist School Librarian University/College Librarian Non-Librarian: Consumer Non-Librarian: Professional Principal/Assistant Principal Other
Nominee Library or Professional Address * :
Nominee Library or Professional Address 2 :
AL AK AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WI WV WY AB BC MB NB NL NT NS NU ON PE QC SK YT International
Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Ashmore and Cartier Islands Australia Austria Azerbaijan Bahamas, The Bahrain Baker Island Bangladesh Barbados Bassas da India Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Clipperton Island Cocos (Keeling) Islands Colombia Comoros Congo, Democratic Republic of Cook Islands Costa Rica Cote d'Ivoire Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Europa Island Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern and Antarctic Gabon Gambia, The Gaza Strip Georgia Germany Ghana Gibraltar Glorioso Islands Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See (Vatican City) Honduras Hong Kong Howland Island Hungary Iceland India Indonesia Iraq Ireland Israel Italy Jamaica Jan Mayen Japan Jarvis Island Jersey Johnston Atoll Jordan Juan de Nova Island Kazakhstan Kenya Kingman Reef Kiribati Korea, South Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Man, Isle of Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Midway Islands Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Navassa Island Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palmyra Atoll Panama Papua New Guinea Paracel Islands Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia Spain Spratly Islands Sri Lanka Suriname Svalbard Swaziland Sweden Switzerland Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tromelin Island Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands Wake Atoll Wallis and Futuna West Bank Western Sahara Yemen Zambia Zimbabwe
YOUR INFORMATION: Nominator Library or Organization * :
Nominator Professional Title * :
Nominator Job Category * :
Please select ... Adult/Public Library Services Librarian Assistant Library Director Cataloging Librarian Children’s Services Librarian Circulation/Access Services Librarian Collection Development/Acquisition Librarian Electronic Resources Librarian Emerging Technologies Librarian Head Librarian Library Director Library/Branch Manager LIS Student Outreach Librarian Paralibrarian/ Paraprofessional Readers Advisory Librarian Reference/Information Services Librarian School Library Media Specialist Teacher Librarian Technical Services/Systems Librarian YA/Teen Librarian Youth Services Librarian Curriculum Coordinator Reading/Literacy Specialist School Librarian University/College Librarian Non-Librarian: Consumer Non-Librarian: Professional Principal/Assistant Principal Other
Nominator Business Category * :
Please select ... Academic Library: 2 year/Community College Academic Library: 4 year/University/College Business/Corporate Library Consortia or Buying Group Government Library Law Library Library Association Library Vendor Public Library (Branch) Public Library (Main) Publisher School Library/Media Center School District Private/parochial School Elementary School Middle/Junior High School High School K-8/K-12 Combined School State Library Home School Preschool/Daycare Hospital/Medical Military Other
Nominator Library or Professional Address * :
Nominator Library or Professional Address 2 :
AL AK AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WI WV WY AB BC MB NB NL NT NS NU ON PE QC SK YT International
Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Ashmore and Cartier Islands Australia Austria Azerbaijan Bahamas, The Bahrain Baker Island Bangladesh Barbados Bassas da India Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Clipperton Island Cocos (Keeling) Islands Colombia Comoros Congo, Democratic Republic of Cook Islands Costa Rica Cote d'Ivoire Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Europa Island Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern and Antarctic Gabon Gambia, The Gaza Strip Georgia Germany Ghana Gibraltar Glorioso Islands Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See (Vatican City) Honduras Hong Kong Howland Island Hungary Iceland India Indonesia Iraq Ireland Israel Italy Jamaica Jan Mayen Japan Jarvis Island Jersey Johnston Atoll Jordan Juan de Nova Island Kazakhstan Kenya Kingman Reef Kiribati Korea, South Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Man, Isle of Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Midway Islands Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Navassa Island Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palmyra Atoll Panama Papua New Guinea Paracel Islands Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia Spain Spratly Islands Sri Lanka Suriname Svalbard Swaziland Sweden Switzerland Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tromelin Island Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands Wake Atoll Wallis and Futuna West Bank Western Sahara Yemen Zambia Zimbabwe
Nominator Email Address * :
Nominator Phone Number * :
REASONS FOR NOMINATION:
FOR THESE THREE QUESTIONS, PLEASE PROVIDE ENOUGH DETAIL TO HELP US MAKE A FAIR DECISION. THERE IS NO WORD LIMIT.
REFERENCES:
Please list at least one person we may contact to discuss information provided about the nominee. 1st Reference First Name * :
1st Reference Last Name * :
1st Reference Job Title * :
1st Reference Library or Organization * :
1st Reference Email Address * :
1st Reference Phone Number * :
2nd Reference First Name :
2nd Reference Last Name :
2nd Reference Job Title :
2nd Reference Library or Organization :
2nd Reference Email Address :
2nd Reference Phone Number :
Please note, we are unable to contact every nominator to let them know whether their nominee has been selected, but we will get in touch directly with those who have been selected as Movers.