Registration

Thank you for your interest and willingness to give your thoughts and feedback on the State Library's 2013-2017 Library Services and Technology Act (LSTA) Five Year Plan.  Registration is due by October 21, 2016.

Please indicate your first and second choice for attending the focus group.

If you are unable to attend, please indicate your designee.

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* 1. Participant Name (Last)

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* 2. Participant Name (First)

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* 3. Library

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* 4. Address

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* 5. City, State, and Zip Code

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* 6. Phone Number (XXX-XX-XXXX)

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* 7. Email Address

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