REQUEST FOR APPROVAL OF Practicum (For Certificate in ...
REQUEST FOR APPROVAL OF Practicum (For Certificate in CT or MAIS-CCT)
Student G#
Requests approval of the practicum described below:
Title: CTCH 685 Practicum
Practicum Site
Organization
Practicum Mentor (Name/Title)
Semester and year to be taken
Practicum Proposal should include the following:
1. A statement of purpose and rationale;
2. A description of workplace responsibilities;
3. A description of how the purpose of the practicum will be accomplished;
4. A description of the criteria against which the supervisor/mentor will evaluate the practicum; and
5. A plan of work (minimum of 200 hours for three credits, this includes research and writing hours).
Required Signatures:
Student Date
Knowledge Area Advisor Date
Practicum Mentor Date
Director of Academics Date
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