Contact and Subscription Form

* Mandatory fields

*Institution Name

Select your Library/Institution or ESLN Council(Select "non-member" "student" "unemployed" if applicable)

Other

ONLY complete if your institution not listed above or if your institution is a member of ESLN (select the appropriate ESLN council above)

*First name

*Last name

*Professional Title

*Professional Email

*Phone

XXX-XXX-XXXX

*Work Address1

Work Address2

*City

*State

*Zip

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Long Island Library Resources Council
627 N. Sunrise Service Road
Bellport NY, 11713
Phone: (631) 675-1570
info@lilrc.org