LCP Leadership Practicum Proposal LCP members must submit (and have approved) a Leadership Practicum Proposal to officially start their practicum project. If you have any questions, please contact John Bowen, coordinator of leadership programs, at [email protected]. Personal Information Please complete all required fields. [Required] Name [Required] Preferred Telephone Number [Required] Preferred Email Address [Required] Practicum Agency's Name The Agency is the organization, program, project, initiative, etc. with which you will work to complete your leadership practicum. [Required] Which Of The Following Is Your Agency? Valid input: - Select only one choice. [ [ [ [ ] A Georgia College Recognized Student Organization (RSO) ] A Georgia College Unit (Department, Program, Office, Etc.) ] A Community Partner (Business, Non-Profit, School/Youth Group, Etc.) ] None Of The Above [Required] Title Of Your Position With The Identified Agency For example, President, Service Committee Chair, Project Coordinator, etc. Name your role if you don't have an official title. [Required] Practicum Mentor's Name The Mentor is an individual who works with your listed agency in some capacity and is in a position to provide you with guidance, support, and feedback throughout your practicum experience. This individual may be a faculty/staff member or community professional who is responsible for the administration of the agency (director, coordinator, etc.), a student who is in a leadership position with the agency, or a faculty/staff member or community professional who is serving as an advisor to the agency. [Required] Practicum Mentor's Title [Required] Practicum Mentor's Email Address [Required] Practicum Mentor's Phone Number [Required] How many hours do you anticipate working in your proposed practicum this semester? Valid input: - Select only one choice. [ [ [ [ [ [ [ [ [ ] 15 to 30 hours (1 to 2 hours per week) ] 31 to 45 hours (2 to 3 hours per week) ] 46 to 60 hours (3 to 4 hours per week) ] 61 to 75 hours (4 to 5 hours per week) ] 76 to 90 hours (5 to 6 hours per week) ] 91 to 105 hours (6 to 7 hours per week) ] 106 to 120 hours (7 to 8 hours per week) ] 121 to 135 hours (8 to 9 hours per week) ] Over 135 hours (over 9 hours per week) Page 1 of 1 · LCP Leadership Practicum Proposal