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Practicum Forms

The forms listed below can be edited online and then printed and signed. Due to legal restrictions, they cannot be submitted electronically, but must be submitted via fax or regular/campus mail to:

Lynn M. Hanson
Practicum Coordinator
Graduate School of Library and Information Science
University of Illinois at Urbana-Champaign
218 Library and Information Science Building, MC-493
501 East Daniel Street
Champaign, Illinois 61820-6211

Telephone. (217) 333-6202
Fax (217) 244-3302
-lmhanson, at uiuc.edu-

Form 1 |Form 2 | Form 3 | Form 4 | Form 5 | Form 6 | Form 7 | Form 8 |

Forms for Students

Form 1

Practicum Resume: RTF Format - This is an optional form which a student can use to document his or her background and experience.

Forms 2-3

Practicum Contract: RTF Format - This is the primary form which establishes the Practicum and must be completed before students can enroll in LIS 591. Each student will work with the Site Supervisor to complete this form documenting the parameters of the Practicum field work, and obtain the Site Supervisor's signature on the form. The form is then approved and signed by the Practicum Faculty Advisor. The student submits the completed form to the GSLIS Practicum Coordinator who will then make arrangements to allow the student to register for LIS 591.

Also included as page 2 of the Contract is Form 3 - Selective Service Compliance Statement: RTF Format - This form enables Site Supervisors to claim the Tuition and Fee Waiver gratuity for their service to GSLIS. Students provide the form to their Site Supervisors to complete, and submit the form to the GSLIS Practicum Coordinator along with the Practicum Contract in order to register for LIS 591.

Form 4

Special Project Abstract: RTF Format - This form documents the Special Project that is a required component of the Practicum course. Each student consults with the Site Supervisor and Practicum Faculty Advisor about the Special Project to be competed. The student writes a description (Abstract) of the proposed project on the form and obtains the Site Supervisor's signature. The form is then approved and signed by the Practicum Faculty Advisor. The student submits the completed form to the GSLIS Practicum Coordinator. The form can be submitted at the same time as the Practicum Contract, or later, after the Practicum field work has started. The form must be submitted by the mid-point date of the Practicum.

Forms for Site Supervisors

Form 3

Statement of Selective Service Compliance: RTF Format - This form enables Site Supervisors to claim the Tuition and Fee Waiver gratuity as a Thank You for their service to GSLIS. Students provide the form to their Site Supervisors to complete and submit the form to the GSLIS Practicum Coordinator along with the Practicum Contract. Alternately, Supervisors may complete and submit the form directly to the Practicum Coordinator.

Form 7

Performance Review: RTF Format - Site Supervisors have the responsibility to provide a written review of the student's activities during the Practicum. Supervisors may use this form to record their review, or use a format of their choice. The Practicum Coordinator can advise Site Supervisors of the deadline for the completion of the Performance Review.

Form 8

Practicum Opportunity: RTF Format - If you would like to post the availability of a Practicum, please complete this form and return it to Lynn M. Hanson, Practicum Coordinator (E-mail -lmhanson, at uiuc.edu-, Telephone 217-333-6202. Fax 217-244-3302).

Additional Forms for K-12 Program Students

Form 5

LIS 591 M Request for Pre-Student Teaching (Practicum) Placement: PDF Format - The student will then take or send this form to the Site Supervisor to obtain the signatures of a) the Site Supervisor and b) the Principal or the District Administrator.

Form 6

LIS 591 M Practicum/Early Field Experience Time Card: PDF Format - The student will keep this Timecard which records time spent on site and time towards project.

Students in the K-12 Program return all forms to:

Georgeann Burch
K-12 Program Coordinator
Graduate School of Library and Information Science
University of Illinois at Urbana-Champaign
501 E. Daniel Street
Champaign, IL 61820-6211

E-mail: -gburch, at uiuc.edu-
Telephone 217-244-0197 Fax 217-244-3302