Request for Waiver

You must check your Program of Study

o General o Digital Imaging Management o Health Informatics o Information Organization o Information Systems

o Youth Librarianship o Law Librarian and Legal Informatics (Letter from Supervisor Required)

l School Library (No waivers accepted. Mentorship required.)

This form must be submitted and approved the semester prior to the semester in which you take the Capstone Experience.

Name Student ID # Date

Home address

Work address

Phone (H) (W) Email

Program of Study______________________________________________Advisor_______________________

Important Notes:

For All Students: 1) Every separate piece of paper must be signed by your supervisor

2) Volunteer work is not applicable to meet the field experience requirement.

Description of experience

Minimum requirements can be met through the sum of experience at one or more institutions. To report experience at more than one institution, complete a separate form for each institution and submit all forms together.

Position Title

Institution Dept Phone

Address

Supervisor Title Email

This is a paid position: Yes o No o

Dates of employment (min 6 months) Hrs worked per week

(over)

Supervisor’s Signature Date

Major responsibilities: (Should be more professional than clerical and involve meaningful intellectual effort, such as answering reference questions, searching, cataloging, developing or maintaining systems or Web sites, teaching or supervising others, budgeting, etc.)

Other responsibilities:

Confirmation of experience (This section to be signed by employer or supervisor)

This is to confirm that the information provided by the student is accurate. I understand that the School my contact me for further information.

Signature Date

Name Title

Address

Phone Email

Comments (optional; attach additional sheet if necessary or send separate letter on letterhead)

Send to: Field Experience Advisor, SLIS/UNT, P.O. Box 311068, Denton, TX 76203-1068

Attn: Waiver Request. Or fax to 940-565-3101. (Voice: 940-565-2445).