Langston University

School of Education and Behavioral Sciences Graduate Program

Department of Rehabilitation Counseling and Disability Studies

Sections of Internship I and II Portfolios: Front Cover Label should have: Special Note: Label should be typed out! Content Includes: aName aCWID # aCourse number and title aSemester Enrolled aInternship Site Location Section I (Internship Agreement)

Content Includes: aInternship agreement(s) aInsurance Certificate [Include proof of payment, i.e. staple receipt to certificate (mandatory)] aInternship Site Request Form aCarl Albert Executive Fellowship Contact (If applicable) aStudent Resume (most current) Section II (Weekly Logs) Content Includes: aWeekly Logs Section III (Clinical Case Studies) Content Includes: aPresentations of Counseling Sessions i.e. clinical case study summarys aInformed Consent form(s) Special Note: Use informed consent forms ONLY if you video or audio record

sessions with clients Section IV: (Evaluations) Content Includes: Evaluation(s) aStudent Intern Evaluation of Supervisor (Student) aStudent Intern Evaluation of Internship Site Form (Student) aIntern Evaluation of Self Form-A (Student) aInternship Experience Evaluation Form-B (Student) aSite Supervisor Evaluation of Intern Form (Site Supervisor) aStudent Intern Individual Internship Evaluation (Faculty) Section V: (Supplemental Documents) Content Includes: aFinal Exam and any supplemental assignments/activities aCRC Code of Professional Ethics aAny additional documents that you may have that support your internship experience, including but not limited to class assignments, article reviews and special projects.