Form

2013 National Library Legislative Day

PLEASE REGISTER BY: Friday April 26, 2013
Full Name*
First Name Last Name
Title

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail*
Phone Number*
- Area Code Phone Number
Please check the event (s) you will attend*

Pre Conference (Training session geared toward first time NLLD attendees) May 6, 2013 Briefing Day (Features numerous sessions on the hot issues affecting libraries in Congress) May 7, 2013 Capitol Hill Visits (To meet with legislators from your state) May 8, 2013
How Many National Library Legislative Day Events have you attended*

First Time 1 - 3 4-6 6-9 10 or more
How did you hear about National Library Legislative Day?

Colleague Conference State Library Association National Library Legislative Day Coordinator Online Library Journal Other
Did you attend the 2012 Legislative Day?
Payment Method. If you are paying by PayPal (preferred method) please select Registration Fee (30.00) then hit the Red Register button to complete your payment. If you are paying by check or money order PLEASE PRINT A COPY OF YOUR COMPLETED REGISTRATION FORM FIRST AND MAIL WITH YOUR CHECK or MONEY ORDER TO THE ADDRESS BELOW. REMEMBER TO Select the Check/MO (free) , then the Red Register button. "YOU DO NOT NEED TO HAVE A PAYPAL ACCOUNT IN ORDER TO PAY BY DEBIT OR CREDIT"

Check ($30.00 per person) (Made payable to the American Library Association) Money Order ($30.00 per person)(Made payable to the American Library Association)
Registration Fee*
Registration Fee $30.00 USD
Check/MO $ Free USD
Mail or Fax to:

American Library Association - WO

1615 New Hampshire Ave NW

First Floor

Washington, DC 20009

202-628-8419
Should be Empty:

2013 National Library Legislative Day