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 * :
  Zip Code * :
     
  Site Type *: Other :
 
     
  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