Nebraska Library Commission
Program Approval Application
For Library Continuing Education
SUBMIT TO: Continuing Education Coordinator, Nebraska Library Commission,
Certification Program, The Atrium, 1200 N St., Suite 120,
Lincoln, NE 68508-2023.
If you have questions or comments about this form, please contact Continuing Education Coordinator
at the Nebraska Library Commission. Phone: 402-471-2694 or 800-307-2665
Program Title:
______________________________________________________
Organization Offering Program: ________________________________________
Program Contact Person: __________________________
Address (including city/state/zip):
_________________________________________________________________
_________________________________________________________________
Phone: __________________
E-mail: __________________
Start Date: ______________
(mm/dd/yy)
Time:
_______________
End Date: ______________ (if more then one
day)
Location (city & facility) ________________________________________
Number of Contact Hours (1 Contact Hour = 60
minute program) : ___________
Number of Participants Expected: ________ Charge to
Each Participant: ______
Target Group:
___________________________________________________________
Topic(s) of Program:
Presenters:
_____________________________ __________________________________
_____________________________ __________________________________
You may add this C.E. event to the online Nebraska Library Training & Events Calendar
by using the "Add an Item" link at the top of the
Calendar web page.
Please submit this form as the workshop is scheduled.
|
________________________________________________ | ______________ |
| Continuing Education Coordinator | Date |
| |
| Office Use Only (Program Number)____________ |