*Your Email
*First Name *Last Name
*Library Name
*Event Format
*Date (the day that you attended the event or the day that you watched the recording)
[ m/d/yy ] single-day event multi-day event
*Start Date *End Date
*Activity / Event Title
Please list sessions attended:
Length:
*Start Time (time you started attending the event or started watching the recording)
[ Examples: 10AM 2:30PM ]
*End Time (time you stopped attending the event or stopped watching the recording)
*Presenter / Speaker Name
*Sponsoring Library or Organization
URL (if available)
Note: submit this form to the Nebraska Library Commission only if you are currently participating in the Nebraska Public Librarian Certification program.
