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Part I: Student/Course Information 

Semester and year requesting to be enrolled: 

Last name:  First name: 

E#:  EIU email address:   Phone: 

Total credit hours earned to date: 

Number of credit hours to be earned for this course: 

Part II: Internship Information 

Describe the proposed internship using the outline below.  

Place of Employment: 

Supervisor Name: 

Supervisor Email Address: 

Learning Objectives (What will you learn from the internship?): 

Human Services and Community Leadership

MS in Human Services Program AdministrationPermission to Enroll in Capstone Experience Coursework

HSL 5980 – Graduate Internship

Note:

a. Student must make reference to the graduate internship packets (student packet and site supervisorpacket) for guidelines on this capstone experience. This can be found on the HSCL website. Page 4 of thisenrollment document shares guidelines on how to fill Part III (Capstone Requirements) of this form.

b. Student must consult and agree on the proposed internship with Capstone Experience Supervisor beforeseeking permission to be enrolled in this capstone experience coursework.

Fall 2019

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Intern Responsibilities (List all job responsibilities. Be specific): 

Timeline for Completion (What is the start and end date for the internship?): 

Work Hours and Schedule (What days and hours will you work during the internship?): 

Assessment (Identify items that will be submitted to be graded): 

Part III: Capstone Requirements 

Based on the capstone experience and in written and/or oral format, students must be able to demonstrate mastery and comprehension of the following content areas and apply knowledge of the content areas to professional experiences during the internship. A detailed explanation of how each topic will be addressed in your experience is required below. You can refer to page 4 of this document for examples of how each component can be satisfied; however, in collaboration with your Capstone Experience Supervisor, projects of similar rigor may be proposed.  

a. Application of two theories of human development to the daily work of providing human servicesto individuals and families within community settings in the U.S.

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b. Application of research to professional practice

c. Analysis of current public policy

Once signatures are secured, provide a copy to your Capstone Experience Supervisor for this study, your Graduate Coordinator and the HSCL Chairperson, so that you can be enrolled in the course. 

___________________________________________________________ Date  ____________ Student Signature  

___________________________________________________________ Date  ____________ Capstone Experience Supervisor  Signature  

___________________________________________________________ Date  ____________ Graduate Coordinator  Signature 

___________________________________________________________ Date  ____________ HSCL Chairperson  Signature  

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MS in Human Services Program AdministrationInternship Guidelines 

Guidelines on Part III: Capstone Requirements 

Based on the capstone experience and in written and/or oral format, students must be able to demonstrate mastery and comprehension of the following content areas and apply knowledge of the content areas to professional experiences during the internship. Below are examples of how each component can be satisfied; however, in collaboration of your Capstone Experience Supervisor, projects of similar rigor may be proposed.  A detailed explanation of how each topic will be addressed in your experience is required in Part III (page 2‐3) of this document. 

a. Application of two theories of human development to the daily work of providing human services toindividuals and families within community settings in the U.S.

Example: 

An oral presentation can be created related to applying two theories of human development to the daily work of providing human services to individuals and families within community settings in the U.S. and your internship. The delivery mode of the presentation (online or F2F) will be agreed upon between the Graduate Coordinator and student.   

b. Application of research to professional practice

Example: 

Two peer reviewed research articles can be located related to your internship. A content summary, evaluation, and application to this project will be conducted for each article. A 2‐3 page paper (1” margins, Times New Roman) will be submitted.  

c. Analysis of current public policy

Example: 

A minimum of two public policy issues related to your internship can be (2‐3 page paper, 1” margins, Times New Roman) submitted summarizing the policy issues and the impact on your internship experience.