Apply for MLIS Fieldwork Step 1 of 3 33% You MUST consult with and obtain your faculty fieldwork advisor’s approval prior to submitting this form. The fieldwork faculty mentor may be different from your faculty mentor. Please complete this form prior to beginning the fieldwork. You will then be provided permission to register in PAWS for fieldwork. NOTE: The following states stipulate Worker’s Compensation coverage for student experiences requiring affiliation agreements: California, Oregon, Washington, and Colorado. UWM students who plan to do internships, practicum or clinical placements in these states will need to obtain a separate workers compensation insurance policy. The cost of this policy will be the responsibility of the student or sponsoring institution. If you have any questions, please contact Julie Walker: walkerjs@uwm.edu Name* First Last UWM Campus Issued Student ID NumberYour 9-digit UWM Student ID Number is issued after you have been admitted to UWM. You must first be admitted to UWM as a graduate student before completing this form.Email* Program:* MLIS MSIST Today's Date MM slash DD slash YYYY Semester Completing Fieldwork*Are you an onsite or online student?* Onsite Student Online Student Fieldwork credits previously completed?* Yes No # of credits of internship/fieldwork previously completed:# of fieldwork credits you will be taking* 1 credit = 50 hours 2 credits = 100 hours 3 credits = 150 hours MLIS core courses completed:* INFOST 501: Foundations of Library & Information Science INFOST 511: Organization of Information INFOST 571: Information Access & Retrieval MSIST core courses completed:* INFOST 582: Introduction to Data Science INFOST 583: Survey of Information Security COMPST 701: Computing Fundamentals for IT Professionals COMPST 703: Software Development Life Cycle Fieldwork Site InformationOrganization*Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Site Supervisor Name* First Last Site Supervisor TitleSite Supervisor Email* Site Supervisor PhoneBriefly describe the work you will be doing. SOIS Fieldwork Faculty AdvisorName* First Last Email*