Common use of Academic Component Clause in Contracts

Academic Component. I agree to complete all required readings, evaluations, and/or other assignments required by the site and faculty supervisors. Opportunities for Reflection: I will reflect on the observations, experiences, ethical considerations, and other issues that arise during my externship. As directed by my faculty supervisor, I will submit reflection papers or journals analyzing my experiences. In so doing, I will be mindful of my confidentiality obligations. Self-Evaluation: I will strive to self-assess on each assignment I complete. In so doing, I will consider what I did effectively and areas for improvement. Where possible and appropriate, I will discuss my self-assessment with my faculty and site supervisors. I will be open to feedback from my supervisors and will consider how it can be applied specifically and globally to my future work. My externship Start Date is: . The End Date is: . I am enrolled in (#) units for this externship. I understand that to receive credit I must on average (#) hours per week for (#) of weeks, for a total of hours during the session. (Please see the Externship Syllabus for hours-per-unit information.) During this session, I have the following classes and commitments in addition to my externship. In addition to class, examples of commitments include work, office hours, public service, and any other regularly-scheduled events/meetings. Name of Class/Commitment Day/Time/# Hours per week _ Please also indicate whether you will be receiving any compensation for the externship (e.g., hourly wage, transportation/parking cost from the placement or a grant from a third party). Yes No . If “yes,” please explain:

Academic Component. I agree to complete all required readings, evaluations, and/or other assignments required by the site and faculty supervisors. Opportunities for Reflection: I will reflect on the observations, experiences, ethical considerations, and other issues that arise during my externship. As directed by my faculty supervisor, I will submit reflection papers or journals analyzing my experiences. In so doing, I will be mindful of my confidentiality obligations. Self-Evaluation: I will strive to self-assess on each assignment I complete. In so doing, I will consider what I did effectively and areas for improvement. Where possible and appropriate, I will discuss my self-assessment with my faculty and site supervisors. I will be open to feedback from my supervisors and will consider how it can be applied specifically and globally to my future work. My externship Start Date is: . The End Date is: . I am enrolled in (#) units for this externship. I understand that to receive credit I must on average (#) hours per week for (#) of weeks, for a total of _ hours during the session. (Please see the Externship Syllabus for hours-per-unit information.) During this session, I have the following classes and commitments in addition to my externship. In addition to class, examples of commitments include work, office hours, public service, and any other regularly-scheduled events/meetings. Name of Class/Commitment Day/Time/# Hours per week _ Please also indicate whether you will be receiving any compensation for the externship (e.g., hourly wage, transportation/parking cost from the placement or a grant from a third party). Yes No . If “yes,” please explain:

Academic Component. I agree to complete all required readings, evaluations, and/or other assignments required by the site and faculty supervisors. Opportunities for Reflection: I will reflect on the observations, experiences, ethical considerations, and other issues that arise during my externship. As directed by my faculty supervisor, I will submit reflection papers or journals analyzing my experiences. In so doing, I will be mindful of my confidentiality obligations. Self-Evaluation: I will strive to self-assess on each assignment I complete. In so doing, I will consider what I did effectively and areas for improvement. Where possible and appropriate, I will discuss my self-assessment with my faculty and site supervisors. I will be open to feedback from my supervisors and will consider how it can be applied specifically and globally to my future work. My externship Start Date is: . The End Date is: . I am enrolled in (#) units for this externship. I understand that to receive credit I must on average work (#) hours per week for (#) of weeks, for a total of hours during the session. (Please see the Externship Syllabus for hours-per-unit information.) During this session, I have the following classes and commitments in addition to my externship. In addition to class, examples of commitments include work, office hours, public service, and any other regularly-scheduled events/meetings. Name of Class/Commitment Day/Time/# Hours per week _ Please also indicate whether you will be receiving any compensation for the externship (e.g., hourly wage, transportation/parking cost from the placement or a grant from a third party). Yes please explain: No . If “yes,” please explain:”