External Review Panelist Information Form

AASL/CAEP Program Reviewer Application Form

Please complete the form and return with your current CV or résumé to [email protected]. By submitting this form to the ALA Office for Accreditation, you give your permission for this information to be shared with the AASL-CAEP Coordinating Committee and CAEP.

Name Prefix Name Date

Preferred mailing address Address 1 Address 2 Address 3 City State/Province Zip Preferred Business Home mailing address is ()

Phone/Email Work phone Home phone Mobile phone Fax Business email Personal email

Employment Current title Year started Current institution or company Department or school, if applicable Previous employers (institution names only)

Current employment institution type () School library Academic library Library & information studies school Special library Public library Other (specify):

Education Degree  Institution Area of emphasis Doctorate Master’s Bachelor’ s Other

Ethnicity (optional) To help meet the diversity needs of programs, please indicate all that apply (US Census Bureau categories) Black/African American American Indian/Alaskan Native Asian Hispanic/Latino Native Hawaiian/Pacific Islander White

I am aware that this is a volunteer activity. If asked to review, I agree to: Participate in training sessions and reviewer evaluation activities Complete program reviews in advance of deadlines assigned by the review team leader Keep all review-related information confidential AASL/CAEP Program Reviewer Application Page 1 of 2 Signature ______Date ______

AASL/CAEP Program Reviewer Application Page 2 of 2