UWSSLEC Program Information

Name

Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Primary Phone

Primary E-mail

(once you enroll in one of the universities you will be given a university email address and important communications will go there)

Employer

Position

Work Phone

Indicate the semester you wish to begin the program

Fall
Spring
Summer

Year

Indicate ONE campus you will use as your home institution

UW-Madison (must be matriculated at Madison)
UW-Oshkosh
UW-Whitewater

Indicate your anticipated enrollment path. It is important to decide before you begin if you want a master’s degree

Master’s degree candidate seeking add-on library media license (have existing teaching license)
Non-Candidate for degree (NCFD), seeking add-on library media license (have existing teaching license)
Special undergraduate student, full credentials, seeking initial library media license (do NOT have existing teaching license)
Undergraduate minor

Indicate areas of your current teaching license if you are licensed:

Check any of the courses below that you have taken within the past seven years (at either the undergraduate or graduate level)

Finding and Using Information (Reference)
Organizing Information (Cataloging)
Digital Tools (Instructional Technology)
Information Literacy
Library Administration
Children's Literature
Young Adult Literature
Librarians as Leaders

If you answered yes to any of the questions above, enter the term you took said course

Finding and Using Information

Organizing Information

Digital Tools

Information Literacy

Library Administration

Children's Literature

Young Adult Literature

Librarians as Leaders

When you have been assigned an advisor at your home campus, send him or her an unofficial transcript and course syllabus to determine if previously taken courses meet UWSSLEC competencies

List the titles of any teaching methods course you've had in previous licensure programs:

Prior to submitting your application, please read the Basic Technology Needs for UWSSLEC.

I have read the Basic Technology Needs for UWSSLEC and understand that they are required for participation in the program.

How did you learn about UWSSLEC?

Friend or colleague
Internet search
Wisconsin Library Association (WLA) conference
Wisconsin Educational Media and Technology Association (WEMTA) conference
Other