1. Fall 2011 Externship Program Course Application

Please be sure to read the Fall 2011 Applicants page before submitting your application.

Note: You must secure your placement before submitting the application

. ***Remember that with the exception of the Mediation Clinic, you cannot participate in an externship and clinic in the same semester***

Student Name: (Last, First)

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* 1. Student Name: (Last, First)

Current year in school: (Ex: 2L, 2LE)

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* 2. Current year in school: (Ex: 2L, 2LE)

Preferred e-mail address:

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* 3. Preferred e-mail address:

Telephone

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* 4. Telephone

Are you currently taking an externship for credit?

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* 5. Are you currently taking an externship for credit?

If yes, identify your fieldwork placement.

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* 6. If yes, identify your fieldwork placement.

If yes to #5, identify your seminar and professor.

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* 7. If yes to #5, identify your seminar and professor.

Have you previously received academic credit for an externship?
***If you've completed two previous externships, you will need permission if applying for a third.

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* 8. Have you previously received academic credit for an externship?
***If you've completed two previous externships, you will need permission if applying for a third.

If yes, which semester(s)?

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* 9. If yes, which semester(s)?

If yes to #8, identify your previous fieldwork placement(s).

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* 10. If yes to #8, identify your previous fieldwork placement(s).

If yes to #8, identify your seminar and professor.

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* 11. If yes to #8, identify your seminar and professor.

Provide the following information regarding the institution, organization or Court for your proposed externship fieldwork.

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* 12. Provide the following information regarding the institution, organization or Court for your proposed externship fieldwork.

Indicate the externship seminar which you believe is appropriate and your preferred weekday (check only one; if you will be working for a judge, indicate 'Judicial':

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* 13. Indicate the externship seminar which you believe is appropriate and your preferred weekday (check only one; if you will be working for a judge, indicate 'Judicial':

PLEASE DO NOT FORGET TO E-MAIL YOUR RESUME AND TRANSCRIPT IN PDF FORMAT TO EXTERNSHIPS@LAW.FORDHAM.EDU. YOUR APPLICATION WILL NOT BE PROCESSED UNTIL WE HAVE RECEIVED ALL MATERIALS.

THANK YOU!

T