Individual Information (Required items are marked with a * )
* Your
MLA ID#:
* First
Name:
* Last
Name:
* Email
address:
* Daytime
telephone:
Daytime fax:
Institution:
Library:
*
City:
*
State or Province:
(U.S. or Canada only)
Choose
AL Alabama
AK Alaska
AB Alberta
AZ Arizona
AR Arkansas
BC British Columbia
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Col.
FL Florida
GA Georgia
GU Guam
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ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MB Manitoba
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NB New Brunswick
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NL Newfoundland
NC North Carolina
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NW Northwest Terr.
NS Nova Scotia
OH Ohio
OK Oklahoma
ON Ontario
OR Oregon
PA Pennsylvania
PE Prince Edw. Island
PR Puerto Rico
QC Quebec
RI Rhode Island
SK Saskatchewan
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VA Virginia
VI Virgin Islands
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
YT Yukon
Other (outside N. Am.)
*
Country:
United States
Canada
Mexico
Outside North America
*
MLA chapter area:
Select chapter area
Hawaii-Pacific
Medical Lib. Group of S. CA & AZ
Mid-Atlantic
Midcontinental
Midwest
New York-New Jersey
North Atlantic HSL
North CA & NV Medical Library Group
Pacific Northwest
Philadelphia Regional
Pittsburgh
South Central
Southern
Upstate New York and Ontario
Education: Degrees
Granting Institution, City, State/Province
Expertise
Your selections here will be available as a search criteria
for persons seeking a mentor.
Choose up to five
areas of expertise from the topics at left (lists are repeated):
Select expertise area
Academic medical libraries
Academy
of Health Information Professionals
Benchmarking
Cancer libraries
Career development
CE course development
- traditional
CE course development
- Web-based
Clinical medical librarianship
Collection development
Consumer health libraries
Grant writing
History of the health
sciences
Hospital libraries
JCAHO
Library management
Library
space planning, building, renovation
Magnet Hospitals
Meeting papers and
presentations
MLA volunteer roles
Needs assessment and
user surveys
Outreach
PDAs
Publishing/authorship
Research (librarianship)
Research support (biomedical)
Self-directed learning
Technical services
Veterinary medical libraries
Website development
Select expertise area
Academic medical libraries
Academy of Health Information Professionals
Benchmarking
Cancer libraries
Career development
CE course development - traditional
CE course development - Web-based
Clinical medical librarianship
Collection development
Consumer Health Libraries
Grant writing
Hospital libraries
History of the health sciences
JCAHO
Library management
Library space planning, building, renovation
Magnet Hospitals
Meeting papers and presentations
MLA volunteer roles
Outreach
Needs assessment and user surveys
PDAs
Publishing, authorship
Research (librarianship)
Research support (biomedical)
Self-directed learning
Technical services
Veterinary medical libraries
Website development
Select expertise area
Academic medical libraries
Academy of Health Information Professionals
Benchmarking
Cancer libraries
Career development
CE course development - traditional
CE course development - Web-based
Clinical medical librarianship
Collection development
Consumer Health Libraries
Grant writing
History of the health sciences
Hospital libraries
JCAHO
Library management
Library space planning, building, renovation
Magnet Hospitals
Meeting papers and presentations
MLA volunteer roles
Outreach
Needs assessment and user surveys
PDAs
Publishing, authorship
Research (librarianship)
Research support (biomedical)
Self-directed learning
Technical services
Veterinary medical libraries
Website development
Select expertise area
Academic medical libraries
Academy of Health Information Professionals
Benchmarking
Cancer libraries
Career development
CE course development - traditional
CE course development - Web-based
Clinical medical librarianship
Collection development
Consumer Health Libraries
Grant writing
History of the health sciences
Hospital libraries
JCAHO
Library management
Library space planning, building, renovation
Magnet Hospitals
Meeting papers and presentations
MLA volunteer roles
Outreach
Needs assessment and user surveys
PDAs
Publishing, authorship
Research (librarianship)
Research support (biomedical)
Self-directed learning
Technical services
Veterinary medical libraries
Website development
Select expertise area
Academic medical libraries
Academy of Health Information Professionals
Benchmarking
Cancer libraries
Career development
CE course development - traditional
CE course development - Web-based
Clinical medical librarianship
Collection development
Consumer Health Libraries
Grant writing
History of the health sciences
Hospital libraries
JCAHO
Library management
Library space planning, building, renovation
Magnet Hospitals
Meeting papers and presentations
MLA volunteer roles
Outreach
Needs assessment and user surveys
PDAs
Publishing, authorship
Research (librarianship)
Research support (biomedical)
Self-directed learning
Technical services
Veterinary medical libraries
Website development
* Are
you a member of the Academy of Health Information Professionals?
Yes
No
If yes, what level?
Select Level
Provisional
Member
Senior
Distinguished
Mentoring Preferences
Your selections here will be available as a search criteria
for persons seeking a mentor.
In which of the following
mentor capacities would you be willing to serve?
(please check all that apply):
Mentor to provisional members of the academy (visit the academy
mentor site for a list of requirements and responsibilities)
Mentor to new members of MLA or the profession
Mentor to those interested in changing their career to medical librarianship
Speaker about medical librarianship at career fairs, conferences, or high schools
Mentor or host to library school students for half-day or full-day visit to a medical library
Mentor to a colleague seeking my expertise
Other mentoring opportunity (please describe your idea below)
*
How would you prefer to be contacted
by a prospective mentee? (please only check ONE):
telephone
email
*
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