SIS Practicum Application - IS 599

To be completed by the student. Please note the submission due dates for each semester, which can be found on the SIS Practicum page.

Student Name: *

Address:

City:

State:

Zip Code:

Work or Cell Phone:

Home Phone:

Student Email: *

Student's SIS Advisor's Name: *

Name Student's Practicum Supervisor : *

Practicum Supervisor's E-mail:

Number of Credit Hours for which you are applying: *

3 hours

6 hours

Semester during which you wish to be enrolled in the practicum: *

Briefly describe prior and/or current information or library work experience:

Indicate the type of information organization in which you wish take the practicum: *

(e.g., academic library, public library, county archives, university records management office, systems unit.)

Practicum Objectives: *

Develop the educational, professional, or career objectives that a practicum will help you meet by communicating first with your Advisor and then with your Information Agency Practicum Supervisor. List the finalized practicum objectives here.

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