Application form for UW Endorsement program:
School Library Professional 2010-2011 (Program ID# 3218)

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Return to program description

To apply, please print, complete and mail this form with your required materials to the address below.

The 2010-2011 program begins in June 2010. Applications are accepted and reviewed in the order they are received until the program is full. Don't hesitate to call 206-685-8936 or e-mail us if you have any questions.

I wish to apply to the UW Endorsement Program for the School Library Professional. I enclose this completed form with a $50 nonrefundable Endorsement program fee and three stapled application sets, which include a copy of my teaching Endorsement, résumé, letter of application, unofficial transcript, and letter of recommendation.

Note: It is the applicant's responsibility to make sure all required materials are submitted with the application. All applicants will be evaluated on the basis of materials submitted.

Mr.    Ms.
Last name:
First name/middle initial:
Social Security # (required):
Date of birth:
Mailing address:
City/State/ZIP:
Daytime phone:
E-mail address:

Method of payment:

	Check in U.S. funds made payable to the University of Washington. (Returned checks are subject to a $25 service fee.)
	Third-party payer—separate document (purchase order or letter of authorization to bill) must accompany this application.
	VISA
	MasterCard

Card number:
Expiration date:
Name as it appears on card:
Credit card billing address:
City/State/ZIP
Signature: