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Internship Pathway Forms

Program Admissions

This page is for accessing important forms for those on the internship pathway. For more questions about these forms or other intern matters contact our Credential Analyst:

Chris Villanueva

Phone: (831) 582-3613

Email: chvillanueva@csumb.edu

The Intern Handbook & Professional Development Plan

 

Internship Pathway Forms

All interns must complete this form prior to applying for their Intern Credential. Complete this for only if you:

  1. Have completed summer pre-requisite coursework.
  2. Satisfied the CSET/Subject Matter Requirement
  3. Have obtained an intern position at a CSUMB intern partner district. For a list of partner districts see the PDF below this list.
  4. Plan to submit an Intern Credential Application this month. 

Internship Agreement Form

Interns: Please complete this form to verify that you know where to find the Contact Log each week and know the hours and entry requirements. (Please open the Contact Log further below for the requirements.)

Contact Log Receipt Form

 

  1. Download the new form in this site each semester you are serving as an intern (required).
  2. Submit one form per activity completed, or submit it at least once per week, combining that week's activities by checking each applicable box in the "Activities" section. A minimum of 95 hours of mentoring and support must be logged each semester. Of those hours, 23 must be focused on developing your skills for teaching English Learners.
  3. Please keep an external record of your hours. When it comes time to submit your forms, make sure you have saved a copy for yourself as you will no longer have access to them.

Intern Contact Log

This form must be completed by the School Principal or Director to verify that the Support Provider assigned meets all Commission on Teacher Credentialing requirements.

Support Provider Information Form

Interns: Please ask your Support Provider to complete this form. Do not submit this form yourself.

Support Providers: Please complete this form to confirm your agreement to the Support Provider Expectations. If you cannot meet the CTC requirements, please inform your Principal or Director that you will be unable to serve as a Support Provider.

Support Provider Expectation Form

Interns: Please direct your Support Provider to the form below. Do not submit this form yourself.

Support Providers: Please use this form to evaluate the intern a minimum of twice per semester. Spread the two evaluations over the course of the semester. You will be prompted by the Placement Coordinator to complete two additional evaluations using a different system (Taskstream) at the beginning and the end of the semester, if your intern is currently enrolled in a practicum course.

Support Provider Observation Form

A minimum of 45 hours of classroom experience must be verified prior to becoming an intern. Please ask someone who has served in a supervisory role over you in a classroom setting to complete this form to verify 45 hours in a classroom setting have been completed (Principal, Supervisor, Human Resources, etc).

Early Field Experience Verification Form