University of San Diego School of Leadership and Education Sciences Leadership Studies Program Internship Application Section I: Student Information Name : Faculty Advisor:
Progra m:
Semester Internship will begin: Today’s Date:
MA Leadership Studies MA Higher Education Leadership PhD Leadership Studies
Specialization:
EDLD 590 or 593 (Master’s)
EDLD 591 or 592 (Doctoral)
Course number: Section II: Internship Site Information
Internship Site:
Address:
City:
Site Supervisor: Supervisor Phone:
Stat e:
Zip :
SIGNATURES REQUIRED Faculty Advisor: Director of Field Experiences (Peggy Hetherington): Copies to:
Director of Field Expertise Leadership Studies Office Student REV. 11/2008
Registrar
Copies to:
Director of Field Expertise Leadership Studies Office Student REV. 11/2008
Registrar