Service Learning

Practicum Forms

The Practicum Placement Request form (doc) indicates interest in a service-learning or experiential-learning placement. It is used to describe the learning outcomes the student hopes to achieve from the placement and when he or she would like to participate. Students are also required to provide contact information for three members of UMass Lowell faculty or staff who will provide a recommendation for the student's placement.

The Practicum Application Form (doc) is the formal request for practicum, indicating the specific placement, supervisor contact information, job description, and anticipated outcomes. This form is submitted to the Department Internship Coordinator for review.

The Liability Release Form (doc) documents the student's understanding that they are solely responsible for their conduct and safety during their practicum experience.

Forms should be submitted to the English Department's Internship Coordinator, Prof. Diana Archibald. Please leave completed forms and applications in her box in the English Dept. office - do not email them.

Students may contact the English Department Internship Coordinator, Diana Archibald, at any time with questions or ideas. E-mail: or Phone: 978-934-4199.