First Name: Last Name:
School: District: ESC: None 1 - Edinburg 2 - Corpus Christi 3 - Victoria 4 - Houston 5 - Beaumont 6 - Huntsville 7 - Kilgore 8 - Mt. Pleasant 9 - Wichita Falls 10 - Richardson 11 - Fort Worth 12 - Waco 13 - Austin 14 - Abilene 15 - San Angelo 16 - Amarillo 17 - Lubbock 18 - Midland 19 - El Paso 20 - San Antonio Private School Outside of Texas
Mailing Address:
City: State:
Country: Zip Code:
Telephone Number: E-mail Address:
Preferred Contact Method: None E-mail Postal Mail Telephone Personal Visit
What university did you get your Undergraduate Degree from: Undergraduate Major Field of Study:
What university did you get your Master’s Degree from: Master’s Major Field of Study:
What university did you get your Teacher’s Certification from:
What university did you get your Library Certification from:
Is your Library Certification by exam only? Yes No
How many years of Library Experience do you have? less than three three or more
Are you currently in a school library? Yes No
Short Biography:
Statement of Job Responsibilities:
School Library Experience:List beginning and ending dates and levels - 3 years minimum required:
