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Library Media Interest / Admittance Form

If you are interested in the School Library Media Endorsement / Minor or would just like more information, please complete this form and submit. You will also need to send a copy of your transcript. We will contact you shortly.

If you would rather print out an admission form and fax or mail it in, use one of these: LM Admission Form [Word] [PDF]

Name: Last, First and Middle Initial

Address:

City:

State:

Zip:

E-mail address:

Phone:

Applying to receive: Minor (17 credits) Undergraduate Endorsement (18 credits)
  Graduate Endorsement (18 credits)  

Education History - Please provide a brief summary of your educational background:

DEGREES

LICENSE/CERTIFICATIONS

CURRENT EMPLOYMENT

Courses taken at other institutions that you would like us to consider for substitution for courses in this program.
All courses must be completed within ten years of completion of the license/ minor. Please attach all official transcripts and catalog course descriptions. For license, 12 of 21 hours must be taken at SUU. For minor, 9 of 17 hours must be completed at SUU.