INTERNSHIP
APPEAL FORM
This form is for any student wishing to appeal an internship admission decision. The student must make such an appeal in
accordance with the policies and procedures established by the USCB Department of Education’s Professional Program
Committee.
TO BE COMPLETED BY STUDENT:
Name: ______________________________________________________________________________
Student ID Number: ___________________________________________________________________
Current Phone Number/e-mail:___________________________________________________________
Expected Graduate Date: _______________________________________________________________
In order to complete an appeal to be considered to enter the internship, the student must address the following
criteria:
(1) He/she made at least two attempts to take and pass the Praxis II exam (include test dates and scores);
(2) Write a compelling statement of how you have made efforts to improve your score; and
(3) Write a compelling statement for your next step to try to improve your score (attach additional sheets if
needed).
Signature of Student: _________________________________________ Date: ____________
TO BE COMPLETED BY DEPARTMENT CHAIR:
Approved: ___________ Not Approved:____________
Signature:______________________________________Date:__________________
Comments: