Forms (post-Fall 2019)

This packet contains the Internship Proposal Form and Work Plan. This packet is completed by the student intern and submitted to the APE Coordinator after obtaining the proper signatures and detailing the work plan. Only students with an approved proposal will be registered for internship credits.

This form must be used to log your internship hours. The form must be completed by the student and signed by the preceptor.

This form is to be completed by the student intern as a means to evaluate their internship experience. It must be submitted no later than Public Health Day.

Students should be tracking their PHS hours throughout their time in the program.

Students should complete a factual report for each public health service opportunity.

This rubric is used by the Faculty Advisor to assess the work products submitted by the student.

This form completed by the student at the start of their internship, outlining the portfolio work products they will develop during their internship. The faculty advisor signs off on this form before the student submits it to Canvas.

This is a list of the MPH Core (and concentration) Competencies for reference. During their internship, students must address a minimum of 5 public health competencies, at least three of which must be MPH core competencies.