First Name:   Last Name: 

Mailing Address: 

City:   State:  Select a StateTexasNot Applicable----------Air Atlantic (AA)Air Europe (AE)Air Pacific (AP)AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaCaroline IslandsColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarianas IslandsMarshall IslandsMarylandMassachusettsMichiganMicronesiaMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUs Virgin IslandsUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon   Zip Code: 

Telephone Number:    E-mail: 

First Name:   Last Name: 

Title:  Agency: 

Mailing Address: 

City:    State:  Select a StateTexasNot Applicable----------Air Atlantic (AA)Air Europe (AE)Air Pacific (AP)AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaCaroline IslandsColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarianas IslandsMarshall IslandsMarylandMassachusettsMichiganMicronesiaMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUs Virgin IslandsUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon   Zip Code: 

Telephone Number:    E-mail: 

Prior to registering for SLIS 5090.701, students must have completed a minimum of 12 semester hours of Library and Information Sciences course work. Students are encouraged to register for SLIS 5090.701 in their last semester of course work.  Please list all courses and grades you have completed within Library and Information Sciences.