PSYC 391 Application

PSYC 391
USC Dornsife
College
DIRECTED FIELD EXPERIENCE IN PSYCHOLOGY
APPLICATION
How do I enroll?
Step 1: Identify an Internship site. Some sources of sites are:
 Our list of previously held internships https://dornsife.usc.edu/assets/sites/210/docs/Intern_Book.pdf
 Your own contacts
Identify some areas of interest to you. Students may propose an internship opportunity that is
related to any area of psychology. The internship must be approved by Dr. Prescott.
Step 2: Email the Course Coordinator, Dr. Prescott ([email protected]), to schedule a brief
conversation about the course and potential internship. During that conversation, you will be
given guidance on finding a Faculty Mentor.
Step 3: Contact the internship site. Request an application if the site has their own application
process. Provide the on-site Supervisor with a copy of the PSYC391 syllabus, discuss your
available hours and mutual expectations, and have your on-site Supervisor sign the Internship
Agreement Form on the last page of this application. Find out if the site has any other
requirements prior to beginning (e.g., special training, fingerprinting, TB tests).
Step 4: Email your prospective Faculty Mentor to ask if she/he might be willing to be your Mentor.
Tell a little about yourself, about the internship site and what you will be doing there. Email a copy of
the PSYC 391 Syllabus and Agreement form (this document). Request a meeting to discuss your
plans and goals for 391. Take a copy of the filled-out Agreement form (the remainder of this
document). Make sure that the Mentor approves of the plan on your proposal form, including the
topic of the paper, and signs your application.
Step 5: Bring your Internship Agreement form with both Faculty Mentor and on-site Supervisor
signatures, and the Waiver of Liability Form (including Parent Signature if you are under age 18), to
Dr. Prescott (SGM 934 or Mailbox in SGM 501). You must do this no later than the third week of
classes (i.e., before Drop/Add day). After your application is approved, you will receive an email
saying you can register online for Psych 391.
PSYCHOLOGY 391
DIRECTED FIELD EXPERIENCE IN PSYCHOLOGY
Internship Agreement – page 1
Application Requirements: Psychology Major or Minor, Introduction to Psychology, minimum
overall GPA 3.00.
Student Name (print)
Student ID #
Student Phone Number
Student e-mail address
Major
Overall GPA
# 391 Units taking
taken 391 previously?
Year in School
Semester/Year
Will you continue 391 next semester?
________________________________________ ____________________________________________________________
Internship Agency Name
Internship Address
On-site Supervisor
Supervisor phone#
Supervisor e-mail address
Other Agency Contact Person
Contact phone#
Contact e-mail address
USC Faculty Mentor
Mentor phone#
Mentor e-mail address
List all Psychology courses completed and Grade (specify institution if other than USC):
Course Title/No. (College)
Grade
Course Title/No. (College)
Grade
_____ __________
_____ __________
_____ __________
_____ __________
_____ __________
_____ __________
PSYCHOLOGY 391
DIRECTED FIELD EXPERIENCE IN PSYCHOLOGY
Internship Agreement – page 2
Briefly describe the activities you will perform at your internship site:
Briefly describe your plan for the paper you will write, integrating psychological theory
with your experiences at the internship. (See Course Syllabus for more detail).
Student signature & date
Faculty Mentor signature & date
On-Site Supervisor signature & date
APPROVAL:
Course Coordinator
Carol Prescott, Ph.D.