Fieldwork Site Registration Form
Instructions :
Please fill out the following form. The items marked with
*
are required. Thank you for your interest!
SITE LOCATION and OTHER DETAILS :
Site Name
*
:
Address
*
:
City
*
:
State
*
:
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
Canal Zone
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Northern Mariana Is
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Trust Territories
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
Zip Code
*
:
Site Type
*
:
Other :
--Select One--
Academic Library
Art Library
Health Sciences Library
Health Sciences Agency
Information Services Company
Law Library
Museum Library
News Library
Public Library
School Library
Special Library
University Department
Is a car needed
*
?
Yes       
No
Is the internship paid
*
?
Yes       
No
Pay Range :
    as of Date :
  (yyyy-mm-dd)
Type of Work Experience
*
: (please check all that apply.)
Acquisitions
News Research
Archives
Reference
Cataloging
Research
Children's Services
Reserves
Collection Development
School Media
Database Design
System Administration
Digitization
Technical Services
Instructional Technology
Web Development
Manuscripts
Web Instruction
Multiple Assignments
Web Page Maintenance
Museum Work
Other (Please Specify) :
Networks/Computer Services
Description of work or/and type of skills needed prior to work experience :
CONTACT :
Name
*
:
Telephone
*
:
(
) -
-
Ext.
Fax :
(
) -
-
Email Address
*
:
SUPERVISOR (if different from contact) :
Name :
Telephone :
(
) -
-
Ext.
Email Address :
Thank you for your interest and support of our students.
Dr. Evelyn H. Daniel, Internship Coordinator
School of Information and Library Science
CB#216 Manning Hall
University of North Carolina at Chapel Hill
Chapel Hill, NC 27599
Phone : (919)-962-8062
Email :
daniel@ils.unc.edu