Or Fax: 501 852-2826, Attn: Dr. Huffman

Practicum Application

Submission Deadlines

May 1=Fall/September 1=Spring/February 1=Summer

Name: Advisor: ☐ Jud Copeland

Cell: ☐ Stephanie Huffman

Email: ☐ Helen Hu

Date: UCA ID:

Address: City:

State: Zip: Home Phone:

Current Employment

School District: Campus:

Address: City:

State: Zip: Work Phone:

Practicum Information

Practicum Semester: ☐ Fall 20__ Graduation: ☐ Fall 20__

☐ Spring 20__ ☐ Spring 20__

☐ Summer 20__ ☐ Summer 20__

Other information regarding Practicum (i.e., personal commitments, family commitments, etc.):

Proposed Field Sites

☐ Elementary Field Supervisor:

☐ Secondary Email:

School District: Campus:

Address: City:

State: Zip: Work Phone:

☐ Elementary Field Supervisor:

☐ Secondary Email:

School District: Campus:

Address: City:

State: Zip: Work Phone:

☐ Elementary Field Supervisor:

☐ Secondary Email:

School District: Campus:

Address: City:

State: Zip: Work Phone:

☐ Elementary Field Supervisor:

☐ Secondary Email:

School District: Campus:

Address: City:

State: Zip: Work Phone:

Practicum Coordinator

Comments

Approved: ☐ Yes

☐ No Practicum Coordinator

Date

Directions for completion of application:

1.  Read application thoroughly prior to completing.

2.  Candidates must have a placement at the elementary level (K-8) and the secondary level (7-12).

3.  Candidates may use a school librarian(s) within their current district. However, the candidate may NOT complete practicum hours in a library setting in which he/she is currently employed as the librarian for the setting in question.

4.  The candidate may make suggestions on who he/she wishes to serve as their mentors. However, the practicum coordinator will have final authority to approve or disapprove. If the candidate needs assistance in locating a mentor, the practicum coordinator will assist in the process.

5.  A mentor must have the following credentials:

a.  A master’s degree from an accredited institution.

b.  Licensure as a school library media specialist or credentials indicating the individual earned an ALA MLS.

c.  A minimum of two years of experience in a library setting.

6.  Complete the application and submit to Dr. Huffman.

LIBM 6390 Practicum