School of Information Resources and Library Science
Continuing Education (Non-Degree Seeking Students)
APPLICATION FORM
Name: _________________________________________ Application Date: __________
Student ID:______________________________________ Date of Birth: ___________
Present Address:
_________________________________________________
_________________________________________________
Home Phone: _____________________________
Message Phone: _____________________________
Email Address (REQUIRED):
____________________________________________________________
I intend to apply or reapply to the SIRLS Master’s degree program:
YES NO
Semester to begin degree: Year: 20_____
___ Summer Session II/Fall (July) ___ Spring/Winter (January) ___ Summer I (June)
Primary Location: __________ On Campus __________ Virtual
Arizona Resident: __________ Yes _________ No Country of Citizenship: ____________
Level of attendance:
_________ Full time (at least 9 units)
_________ Part time (less than 9 units)
_________ Summer only
Area(s) of Interest (e.g. archives, info technology, public library, etc.):
_______________________________________________________________________________
_______________________________________________________________________________
How did you hear about the program?
_____ Conference exhibit _____ Friend _____ Co-worker
_____ Website, please specify ( SIRLS , ALA , Newsweek, etc____________________
_____ Other, please specify _____________________________________________
