Membership Application

Application for Membership in the Northern New York Library Network

 

Name of Organization ________________________________________________________________

 

Address _____________________________________________________________________________

 

City ____________________________________ State _______ Zip _____________

 

Telephone (voice) ___________________________ Fax ___________________________________

 

Web site: ___________________________________________________________________________

 

Name of Chief Administrator: _________________________________________________________

 

Email address _______________________________________Phone __________________________

 

Type of Organization (check one):

  • _____ College or University Library
  • _____ Public Library
  • _____ Museum
  • _____ Historical Society
  • _____ School
  • _____ Medical
  • Other _________________________________________________________

 

Is the organization chartered by the New York State Board of Regents? _____ yes _____ no

 

Is the organization a part of a larger organization? If so, please identify organization and its relationship to the applicant:

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

Information Concerning the Nature of Library Service 

Number of monographic volumes held: __________
Number of serials titles received: __________
Operating budget for most recently completed fiscal year: __________
Materials budget for most recently completed fiscal year: __________

 Staff:

  • Number of professional staff _____
  • Number of non-professional staff _____
  • Does the Chief Administrator hold an MLS degree? _____ yes _____ no

 Service:

  • Number of hours library is open weekly: _____
  • Is library open to the public? _____ yes _____ no

 Special Collections:

  • Number of items: _____
    Please briefly describe Special Collections:

     

    ______________________________________________________________________________________

     

    ______________________________________________________________________________________

     

    ______________________________________________________________________________________

 

Education Commissioner Regulation 90.5 requires that each reference and research library resources system shall demonstrate how any new member will improve library resources presently available to the research community in the area of the system, and/or bring improved reference and research services to the users of such new member. Please briefly address this requirement (for example, through participation in resource sharing, digitization of special collections, shared expertise in training, etc.):

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

Dues: Full Voting Membership

Dues are based on type of membership which is determined by Network by-laws in accordance with regulations of the Education Commissioner of the State of New York. Current dues are:

  • Organizations that award Graduate degrees: $225.00
  • Organizations that award Undergraduate degrees: $187.50
  • Library Systems: $112.50
  • For-Profit Institutions: $150.00
  • All Others: $52.50 

Certification 

On behalf of the ____________________________________________________________________, I hereby apply for membership in the Northern New York Library Network. I agree to adhere to the bylaws and practices of the organization, and share resources within the region at no charge.

Print Name _________________________________________________________________

 

Signature __________________________________________________________________

 

Title ________________________________________________________________________

 

Date _________________________________________

Please return this application to:
John Hammond, Executive Director
Northern New York Library Network
6721 US HWY 11
Potsdam, NY 13676