Public Interest Practicum

Student Disclosure Form


Please fill out completely and honestly. Failure to do so may jeopardize your ability to participate in the Public Interest Practicum program. This form must be completed, signed and submitted before beginning your practicum.

Please indicate any law-related employment, internships, or volunteer work in which you are currently participating or will be participating at the time you anticipate doing your practicum work.

I acknowledge that the above information is accurate and true.

Student Signature
Student ID Number
Email Address