Escue Stipend Application Form

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Library
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Telephone
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e-mail
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Position
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Immediate supervisor
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Supervisor's title

On a separate page provide the following:

List your library work experience, most current position first.
In about 250 words, state your need for this stipend, incorporating your personal development and job-related growth you anticipate from attending the TLA Conference. Please indicate how this will benefit your library. Include any other facts you consider relevant to this award.
Request your immediate supervisor or library director to submit a letter of recommendation to the Chair, Scholarship & Research Committee.

Acknowledgment: If selected, I agree to assist in the TLA booth for four (4) hours during the conference and to submit a report on the Conference to the TLA Executive (copy to the Chair, Scholarship & Research Committee) within thirty (30) days after the end of the conference.

Signature: __________________________________________ Date: ___/____/_______

On a separate page provide the following:

Send completed applications to:

Deadline for receipt of completed application and letters of reference is December 15, 2006.