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Public Interest Practicum

Supervisor Acceptance Form

Public Interest Practicum

Supervisor's Acceptance of Public Interest Practicum Student

 

Supervisor's Name
Organization
Address
City     State     Zip
Email
Telephone    Fax

I have met with and have accepted him/her as my practicum student for the   fall    spring    summer (check one) semester.

The Student's Practicum will begin on: (date)

Describe the assignment and main duties the student will undertake:

Do you estimate that the practicum work will require more than the minimum 50 hours to complete?
Yes    No
If yes, how many hours all together are estimated?

Other comments relating to this practicum placement:

I confirm that the above student will receive professional supervision.

Supervisor's Signature
Attorney's License Number
Date