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Welcome to the Wyoming Library Association

Nora Van Burgh Development Grant Application

Name:  


Preferred Address:


Phone (Day):


Phone (Evening):


Position:


Library:


E-mail:  


Are you presently a member of WLA?: Yes  No   
For two years or more? Yes  No

Title of Program:


Dates and location of event:


Description of Program:


Name of Sponsor:


Budget of Expenses:

State the goals you expect to reach with this project::


How will you measure the success and effectiveness of the project to you personally, and to your library?:


Are you willing to be available during theWLA confernce to be introduced, make presentations, or put up a display about the project and your experience?
Yes  No

Print this form out prior to submitting it.

 

After submitting your on-line copy, you must mail ten (10) copies of this form with supporting documentation before June 30th to the:
WLA Awards/Grants Committee
Nora Van Burgh Development Grants
c/o WLA Executive Secretary, Laura Grott
P. O. Box 1387
Cheyenne, WY 82003-1387
E-mail: grottski@aol.com


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