FGCU COE Practicum Application

Practicum Application

First Name / Last Name:	/
Address:
City/State/Zip:	/ /
Phone (home):
Phone (work):
Email Address:
Practicum Semester:	(Ex.: Fall 2006)

You may not take the Practicum in Educational Leadership unless you have completed at least 30 credit hours in the program in Educational Leadership, or unless you will complete 30 hours during the semester you are enrolled. You may begin the Practicum in Educational Leadership in one semester and complete it in another semester without paying an additional fee, if you need the additional time.

You should complete this form and give it to your advisor at least two months prior to the commencement of your practicum. Your advisor will contact your desired mentor to arrange the practicum. You may contact your desired mentor, if you know that he or she has been approved as a mentor--check with your advisor.

Once approved, you will arrange an initial meeting with your university advisor, your school district mentor, and yourself. At this meeting, we will outline your practicum experiences, and you will then write out this agreement. Changes may be made to your plan, with appropriate approvals, as you carry out your practicum.

Do you meet the 30 hour credit hour requirement? Yes No

Suggested name of school or location of practicum:

Name of suggested mentor:

Title / phone number: /

Have you contacted the proposed mentor (this is not a requirement) and if so, what was the result:

Be certain you have completely read the Guide to the Practicum in Educational Leadership and have discussed the requirements with your advisor prior to registering for the Practicum in Educational Leadership course.

Submit the application:

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