NELA Registration – Step One

Application for NELA membership is a two-step process. On this form, you will enter your name, address, etc. Then, you will move to our secure facility to enter your payment information.

Note: Membership fees are based on a sliding scale:
$20 – Annual Salary $15,000 and under
$30 – Annual Salary $15,001 – $25,000
$40 – Annual Salary $25,001 – $35,000
$50 – Annual Salary $35,001 – $45,000
$60 – Annual Salary $45,001 – $55,000
$70 – Annual Salary $55,001 – $65,000
$80 – Annual Salary over $65,000
$30 – Trustee/Friend
$20 – Retired
$15 – Student

Name: *
Name on Credit Card: *
Library/Company: *
Title:
E-mail Address: *	(if none, use none@none.com)
Work Address: *
Work Address Line 2:
City: *
State: *
Zip Code: *
Work Phone: *	(or best contact phone for you)
Work Fax:
Mail Address (if different):
City:
State:
Zip Code:
Member-for-a-Member Sponsor's Name:
Please mark the category that best describes your position: *	Public Librarian Academic Librarian School Librarian Special Librarian Retired Student Government Agency Supplier to librarians Trustee/Friend Other
Please indicate the section(s) in which you would like to become actively involved:	Academic HQ76.3 (GLBT) Children’s (NERTCL) Intellectual Freedom Information Technology (ITS) Technical Services (NETSL)
Please indicate the committee(s) you would like to join:	Conference Committee Educational Assistance Committee Intellectual Freedom Committee Membership Committee Public Relations Committee

Verification Code:
Enter Verification Code: *


* Required

Please contact our webmaster if you have any problems with your registration.