Practicum Description/Agreement Form

Online form for practicum description/agreement, to be filled out by the placement supervisor at the partnering institution.

Phone

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Student Carleton Email(Required)

Institution Name(Required)

Institution Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Institution Contact Person(Required)

Name, title, email, phone

Institution Supervisor (if different from contact person)(Required)

(Specify name, title, email, phone. Input N/A if not applicable.)

Number and Duration of Practicum (1 or 2 semesters at 144 hours per semester)(Required)

(Choose one of the five options above.)

Description of Practicum Project(Required)

Final Term Paper: Potential Research Topic Areas(Required)

Specific Tasks to Be Performed(Required)

Requirements and Expectations(Required)

(eg. specialized knowledge, experience, aptitude)

Resources Made Available to Student(Required)

(Input N/A if not applicable)

Specific Forms and Approvals Required(Required)

(eg. security clearance, etc. Input N/A if not applicable)

Additional Information as Relevant(Required)

(Input N/A if not applicable)

Date

CAPTCHA

Comparative Studies in Literature, Art and Culture

201 St. Patrick's Building

613-520-2177