FORM #1 -- OVERVIEW: INTERNSHIPS, INDEP. STUDIES & PRACTICUMS

(This form must be completed and submitted to the Program Director prior to the course start date.)

STUDENT NAME:                                                                               SUPERVISOR:                                                                                                                                                                           

STUDENT IS ENROLLED IN:

SAA 775 (1 or 2 credits) - Section _____ (Pass/Fail)                                      

SAA 781(Internship—3 credits) - Section _____

SAA 795 (Independent Study) - Section _____ Credits _____(Choose 1 or 2)

Note: This course experience must take place during the semester you are enrolled in the course.

START DATE:                                                                                      ANTICIPATED DATE OF COMPLETION:                                                                                                                              

DESCRIPTION AND GOALS:

LEARNING OUTCOMES:

RUBRICS: describe what the student must accomplish to earn a passing grade for this course experience

1. To earn an “A” (or “Pass”) for this experience, the student must complete the following:

2. A “B” grade would be earned as follows:

3. A “C” grade would be earned as follows:

4. A “D”, “F,” or “Fail” would be earned as follows:

PROPOSED SCHEDULE OF EVALUATION/ASSESSMENT MEETINGS (with Supervisor):

THIS SERVES AS AN OVERVIEW OF AN INTERNSHIP, PRACTICUM, OR INDEPENDENT STUDY. THIS IS AN AGREEMENT BETWEEN THE STUDENT, SUPERVISOR, AND THE PROGRAM DIRECTOR

Student Signature                                                                   Date                Supervisor Signature                                                   Date