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Beta Phi Mu Omega Chapter - Contact Information Form

All fields marked with * are required.

Personal Information *Last Name:

*First Name:

Middle Name:

Mailing Address:

*Address Line 1:

Address Line 2:

*City:

*State:

*Zip Code:

Country:

Telephone:

*Email:

*Repeat Email:

Email is the preferred way for Omega Chapter to contact its members

I graduated from SJSU SLIS in (month, year):

I accepted nomination to the Omega chapter and was inducted in (year):

I am currently employed: No
Yes, part-time (less than 30 hours a week)
Yes, full-time (30+ hours a week)

If employed either full- or part-time, I work in the following type of organization: Academic Library
Elementary/Secondary School (public or private)
Public Library
Special Library (include medical, art, historical, industrial/corporate, non-profit organizations, museum libraries that are not part of a college or university)
Government Library (state or federal government agencies)
Library Cooperative/Network
Vendor (automation, database, etc.)
Non-profit Organization (not in a library)
Other (please specify):

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