Please complete form and submit at least one month prior to date of program.
Organization Offering Program:
Program Contact Person:
Address:
Telephone:
Fax:
E-mail Address:
Program Title:
Date of Program:
Time:
Location (city and facility):
Describe how the program will be advertised:
Participant Fee (if applicable):
Number of Partipants Expected:
Target Audience:
List the Minnesota Library Certification Program competencies addressed by the program. Under each competency, describe the specific content of the program that addresses that competency.
Describe the homework for this program:
Total Contact Hours by Curriculum Area:
Level I
What is Library Service?
0 hrs.
.5 hrs.
1 hr.
1.5 hrs.
2 hrs.
2.5 hrs.
3 hrs.
3.5 hrs.
4 hrs.
4.5 hrs.
5 hrs.
5.5 hrs.
6 hrs.
6.5 hrs.
7 hrs.
7.5 hrs.
8 hrs.
8.5 hrs.
9 hrs.
9.5 hrs.
10 hrs.
10.5 hrs.
11 hrs.
11.5 hrs.
12 hrs.
12.5 hrs.
13 hrs.
13.5 hrs.
14 hrs.
14.5 hrs.
15 hrs.
15.5 hrs.
16 hrs.
16.5 hrs.
17 hrs.
17.5 hrs.
18 hrs.
18.5 hrs.
19 hrs.
19.5 hrs.
20 hrs.
20.5 hrs.
21 hrs.
21.5 hrs.
22 hrs.
22.5 hrs.
23 hrs.
23.5 hrs.
24 hrs.
24.5 hrs.
25 hrs.
25.5 hrs.
26 hrs.
26.5 hrs.
27 hrs.
27.5 hrs.
28 hrs.
28.5 hrs.
29 hrs.
29.5 hrs.
30 hrs.
Services
0 hrs.
.5 hrs.
1 hr.
1.5 hrs.
2 hrs.
2.5 hrs.
3 hrs.
3.5 hrs.
4 hrs.
4.5 hrs.
5 hrs.
5.5 hrs.
6 hrs.
6.5 hrs.
7 hrs.
7.5 hrs.
8 hrs.
8.5 hrs.
9 hrs.
9.5 hrs.
10 hrs.
10.5 hrs.
11 hrs.
11.5 hrs.
12 hrs.
12.5 hrs.
13 hrs.
13.5 hrs.
14 hrs.
14.5 hrs.
15 hrs.
15.5 hrs.
16 hrs.
16.5 hrs.
17 hrs.
17.5 hrs.
18 hrs.
18.5 hrs.
19 hrs.
19.5 hrs.
20 hrs.
20.5 hrs.
21 hrs.
21.5 hrs.
22 hrs.
22.5 hrs.
23 hrs.
23.5 hrs.
24 hrs.
24.5 hrs.
25 hrs.
25.5 hrs.
26 hrs.
26.5 hrs.
27 hrs.
27.5 hrs.
28 hrs.
28.5 hrs.
29 hrs.
29.5 hrs.
30 hrs.
Collection Management
0 hrs.
.5 hrs.
1 hr.
1.5 hrs.
2 hrs.
2.5 hrs.
3 hrs.
3.5 hrs.
4 hrs.
4.5 hrs.
5 hrs.
5.5 hrs.
6 hrs.
6.5 hrs.
7 hrs.
7.5 hrs.
8 hrs.
8.5 hrs.
9 hrs.
9.5 hrs.
10 hrs.
10.5 hrs.
11 hrs.
11.5 hrs.
12 hrs.
12.5 hrs.
13 hrs.
13.5 hrs.
14 hrs.
14.5 hrs.
15 hrs.
15.5 hrs.
16 hrs.
16.5 hrs.
17 hrs.
17.5 hrs.
18 hrs.
18.5 hrs.
19 hrs.
19.5 hrs.
20 hrs.
20.5 hrs.
21 hrs.
21.5 hrs.
22 hrs.
22.5 hrs.
23 hrs.
23.5 hrs.
24 hrs.
24.5 hrs.
25 hrs.
25.5 hrs.
26 hrs.
26.5 hrs.
27 hrs.
27.5 hrs.
28 hrs.
28.5 hrs.
29 hrs.
29.5 hrs.
30 hrs.
Organization of Resources
0 hrs.
.5 hrs.
1 hr.
1.5 hrs.
2 hrs.
2.5 hrs.
3 hrs.
3.5 hrs.
4 hrs.
4.5 hrs.
5 hrs.
5.5 hrs.
6 hrs.
6.5 hrs.
7 hrs.
7.5 hrs.
8 hrs.
8.5 hrs.
9 hrs.
9.5 hrs.
10 hrs.
10.5 hrs.
11 hrs.
11.5 hrs.
12 hrs.
12.5 hrs.
13 hrs.
13.5 hrs.
14 hrs.
14.5 hrs.
15 hrs.
15.5 hrs.
16 hrs.
16.5 hrs.
17 hrs.
17.5 hrs.
18 hrs.
18.5 hrs.
19 hrs.
19.5 hrs.
20 hrs.
20.5 hrs.
21 hrs.
21.5 hrs.
22 hrs.
22.5 hrs.
23 hrs.
23.5 hrs.
24 hrs.
24.5 hrs.
25 hrs.
25.5 hrs.
26 hrs.
26.5 hrs.
27 hrs.
27.5 hrs.
28 hrs.
28.5 hrs.
29 hrs.
29.5 hrs.
30 hrs.
Technology
0 hrs.
.5 hrs.
1 hr.
1.5 hrs.
2 hrs.
2.5 hrs.
3 hrs.
3.5 hrs.
4 hrs.
4.5 hrs.
5 hrs.
5.5 hrs.
6 hrs.
6.5 hrs.
7 hrs.
7.5 hrs.
8 hrs.
8.5 hrs.
9 hrs.
9.5 hrs.
10 hrs.
10.5 hrs.
11 hrs.
11.5 hrs.
12 hrs.
12.5 hrs.
13 hrs.
13.5 hrs.
14 hrs.
14.5 hrs.
15 hrs.
15.5 hrs.
16 hrs.
16.5 hrs.
17 hrs.
17.5 hrs.
18 hrs.
18.5 hrs.
19 hrs.
19.5 hrs.
20 hrs.
20.5 hrs.
21 hrs.
21.5 hrs.
22 hrs.
22.5 hrs.
23 hrs.
23.5 hrs.
24 hrs.
24.5 hrs.
25 hrs.
25.5 hrs.
26 hrs.
26.5 hrs.
27 hrs.
27.5 hrs.
28 hrs.
28.5 hrs.
29 hrs.
29.5 hrs.
30 hrs.
Level II
Management
0 hrs.
.5 hrs.
1 hr.
1.5 hrs.
2 hrs.
2.5 hrs.
3 hrs.
3.5 hrs.
4 hrs.
4.5 hrs.
5 hrs.
5.5 hrs.
6 hrs.
6.5 hrs.
7 hrs.
7.5 hrs.
8 hrs.
8.5 hrs.
9 hrs.
9.5 hrs.
10 hrs.
10.5 hrs.
11 hrs.
11.5 hrs.
12 hrs.
12.5 hrs.
13 hrs.
13.5 hrs.
14 hrs.
14.5 hrs.
15 hrs.
15.5 hrs.
16 hrs.
16.5 hrs.
17 hrs.
17.5 hrs.
18 hrs.
18.5 hrs.
19 hrs.
19.5 hrs.
20 hrs.
20.5 hrs.
21 hrs.
21.5 hrs.
22 hrs.
22.5 hrs.
23 hrs.
23.5 hrs.
24 hrs.
24.5 hrs.
25 hrs.
25.5 hrs.
26 hrs.
26.5 hrs.
27 hrs.
27.5 hrs.
28 hrs.
28.5 hrs.
29 hrs.
29.5 hrs.
30 hrs.
Instructional staff:
Name:
Subject Qualifications:
Evaluation: Describe the process you plan to use.
Confirmation of attendace will be by:
CEU's (please specify number)
Letter provided upon request
Certificate of Attendance
List of attendees distrubed at event
Other
Date of application:
Additional Information. Course description or outline:
Your form is being sent to Rebecca Patton at the Arrowhead Library System for consideration by the Certification Oversight Committee. If you have workshop outlines or documentation that is not included on this form, please fax them to Rebecca Patton at 218-748-2171. You will be contacted after the Certification Oversight Committee has reviewed this application.
