Externship and Practicum Enrollment Form

Instructions:

You must submit this form to be enrolled in an externship or a practicum.

You must secure the externship before submitting this enrollment form.

For summer externships, this form must be submitted on or before the Friday before the summer externship orientation class.

For fall and spring externships, this form must be submitted at least one week before the semester begins.

Student Information

First Name: *

Last Name: *

Class: *

Student ID: *

�޻��ֱ�� Law Email Address: *

Number of credits you wish to receive for this externship: *

Note:��All summer externships and all judicial externships are limited to 3 credits. ��See work time requirements for various credit amounts.

List all other externships for which you have been approved, including those which you have not yet completed. For judicial externships, enter the judge's name and court.

Externship Placement Information

Name of Externship Placement: *

��ǳٱ�:��This is the name of the judge, government office, nonprofit organization, law firm, or corporate law office for which you will be externing.

Semester of Externship (Semester, Year): *

How did you secure this externship? *

If you selected "Other" for how you secured the externship, please explain:

Name of Supervising Attorney: *

Address (Line 1):

Address (Line 2):

City:

State:

ZIp Code:

Telephone: *

Externship Email Address: *

Externship Website:

Detailed description of the work to be performed:

Will you be paid for your work? *

Will you be working on-site, remotely/virtually, or a combination of on-site and remotely? *

Externship Guidelines

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Before completing, please read the Program Requirements.

Please check the boxes to confirm that you understand the externship program guidelines. I have read and understand the Program Requirements. I understand and agree that, if I accept an externship, I am making a commitment to the externship placement and that I am obligated to follow through until the conclusion of the summer / semester. I also understand that I will not be permitted to withdraw from the externship absent extraordinary circumstances and the approval of the Academic Dean as well as the faculty advisor for the externship. If I choose to accept, I am committing that I will not transfer to another school, attend a different school as a visiting student, or study abroad during the summer / semester of the externship. I understand that I may not participate in an externship and a clinic in the same semester and that, if I accept a place in a clinic, I am required to withdraw my externship application immediately and notify the Director of Experiential Learning. (Summer Externs Only) I understand and agree that in order to receive academic credit, I must not receive payment of any kind, including work-study, for my externship. (Summer Externs Only) I understand that I must participate in the intensive class component, the first part of which will take place in May, the week after the Spring semester finals period ends, and the second part of which will take place in August at the beginning of the Fall semester. (Summer Externs Only) I understand that my failure to return to �޻��ֱ�� University School of Law for the following Fall semester for any reason will bar me from receiving credit.

Faculty Advisor Information

Name of Faculty Advisor: *

Note: For approved placements, the faculty advisor is listed on the externship course description. ��For independent placements in the Fall and Spring semesters (except judicial externships), a member of the law school faculty must agree to serve as your faculty advisor before you submit this form. ��For all summer externships, list Matthew McGovern as your faculty advisor.

By submitting this form, you certify that the faculty member named above has agreed to serve as your faculty advisor for this externship.

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