INTERNSHIP PROPOSAL AND INTERN AGREEMENT FORM
Government Office/Non-Profit Organization/Law Firm Name:
Supervisor Name: ________________________________________________
Check one: ☐ Legal Internship ☐ Advanced Legal Internship
The Internship program at the Colleges of Law has several educational goals for students, including (1) the training of students
in lawyering skills; (2) the acquisition of insight into the workings of various aspects of the legal system and profession; (3)
the encouragement of a sense of professional responsibility; (4) the development of students’ ability to reflect on and learn
from their experience; and (5) facilitating students’ career planning.
Completion of this form is one of the required steps in securing approval for any internship for which a student wishes to
receive academic credit. Although up to three (3) units may be earned for Legal Internship, a one (1) unit Legal Internship is
a graduation requirement. Additionally, after completion of Legal Internship, students may earn additional units for Advanced
Legal Internship. Please see Section 8.7 Legal Internship of the Academic Catalog for additional information.
Please complete all five (5) parts of this form and return it, along with the Internship Supervisor Agreement Form, to (insert
name and position) at (insert email or other instructions for submitting form).
Part 1. Student Intern Information
Ruth Barcenas-Silva Summer 2024
Student Name: Semester/Year:
✔ Onsite JD
Student Program (Check one): ____ _____ Hybrid JD
1355 Springline Drive, Palmdale CA, 93550
Student Address:
[email protected] 661-406-6089
Student Email: Student Phone:
Part 2. Type of Internship and Number of Units
Please initial next to the type of internship and write in the number of units for which you are seeking approval.
x 1
_____ Legal Internship for _______ Units. Note: This internship is required for graduation and must be completed prior to
Advanced Legal Internship. The Legal Internship must be at least one (1) unit but may be up to three (3) units with the
approval of the Dean or the Dean’s designee. In addition to the required 50 hours of law related work in the field (per unit),
students must also complete the Legal Internship Orientation, attend Legal Internship classes (via Zoom), and complete all
INTERNSHIP PROPOSAL AND INTERN AGREEMENT FORM 1
assignments to receive academic credit. The Legal Internship unit must be completed by doing only pro bono work. Work
for which the attorney or firm is or expects to be compensated is not eligible for the required Legal Internship.
If seeking approval for Initial internship, please ensure that you have first completed the Legal Internship Orientation.
_____ Advanced Legal Internship for ______ Units. Note: This internship may be done only after a student has
successfully completed and received credit for the required Legal Internship. This internship must be at least one (1) unit, but
no more than three (3) units unless exceptional circumstances apply. In addition to the required 50 hours of law-related work
in the field (per unit), students must also complete all assignments to receive academic credit. In total, a student may elect to
earn up to 6 units of combined Legal Internship/Advanced Legal Internship/Directed Study with permission of the Associate
Dean.
If seeking approval for Advanced Legal Internship, please provide the following additional information:
Semester/Year that required Legal Internship was completed: _______________________
Placement Site for required Legal Internship: ____________________________________
Number of Units earned for Legal Internship: ___________
Additional units of Advanced Internship or Directed Student earned or for which you are currently enrolled:
Internship/Directed Study (circle one) # of Units: ______ Completed: ☐ Yes ☐ No
Internship/Directed Study (circle one) # of Units: ______ Completed: ☐ Yes ☐ No
Internship/Directed Study (circle one) # of Units: ______ Completed: ☐ Yes ☐ No
Part 3. Type of Internship and Number of Units
Government Office/Non-Profit Organization/Law Firm Name:
Supervisor Name: ________________________________________________ Anticipated End Date: ________________________
Proposed Internship Work/Activity Description: (Note: Credit is not given for clerical, lobbying, or political activities, or
for work for which the intern is compensated.)
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INTERNSHIP PROPOSAL AND INTERN AGREEMENT FORM 2
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Part 4. Intern’s Agreement
Initial each standard and add any comments on this form. As an intern, I agree to the following:
_____ Completion of Legal Internship Orientation: I certify that I have completed the required Legal Internship Orientation
on _______________ (date).
_____ Professionalism: I agree to follow directions, seek clarification and advice in a timely fashion, and comport myself
with professionalism and integrity.
_____ Development Goals: I will create goals for the semester regarding how I plan to develop professionally and will discuss
these with my site supervisor and faculty supervisor.
_____ Opportunities for Reflection: I will reflect on the observations, experiences, ethical considerations, and other issues
that arise during my internship.
_____ Self-Evaluation: I will strive to self-assess on each assignment I complete. In doing so, I will consider what I did
effectively and areas for improvement. Where possible and appropriate, I will discuss my self-assessment with my site
supervisor(s). I will be open to feedback from my supervisor(s) and will consider how it can be applied specifically and globally
to my future work.
_____ Academic Component: I understand that in addition to the field work requirements for an internship, there is also an
academic component that must be completed to receive credit. I agree to complete all required assignments, evaluations,
and forms. This requirement is not subject to waiver.
_____ Required Hours: I understand that for each unit of internship, I must complete 50 hours of law-related work. This
requirement is not subject to waiver.
_____ Completion of Internship: I understand that all internships must be completed by the last day of the semester or
session during which the internship was undertaken, except in extraordinary circumstances approved in advance by the
Director of Internships.
_____ Award of Credit: I understand that the Dean or Dean’s Designee is responsible for deciding whether I received credit
for any internship.
Part 4. Attestation
I have read, understand and accept, and do agree to comply with all the provisions of the Internship program and the
requirements for receiving academic credit from the Colleges of Law as stated in the current Academic Catalog. I
acknowledge that the Colleges of Law cancellation and refund policies have been presented to me in the annual Catalog, a
copy of which has been made available to be on the Student Gateway.
INTERNSHIP PROPOSAL AND INTERN AGREEMENT FORM 3
By signing below, I attest that it is my belief that this internship can fulfill the objective of the Internship program and will
comply with all internship requirements.
Student’s Signature ___________________________________________________________ Date: ________________
Student and Internship information
Student Name: ____________________________________ Student Email: _____________________________________________
Government Office/Non-Profit Organization/Law Firm Name:
Supervisor Name: ___________________________________ Supervisor Email:___________________________________________
Units seeking: _____________
ADMINISTRATION USE ONLY
☐ Internship Supervisor Agreement form completed and received.
The internship proposal is:
☐ granted for _______ units of Legal Internship.
☐ granted for _______ units of Advanced Legal Internship.
☐ denied.
Additional Comments:
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Dean or Dean’s Designee Signature: _____________________________________________ Date: ________________
INTERNSHIP PROPOSAL AND INTERN AGREEMENT FORM 4
