UNIVERSITY OF WISCONSIN-EAU CLAIRE Application
for an Instructional Internship in CSD – CSD 415
Due by the third Friday of March for fall semester
Due by the third Friday of October for spring semester
Name: ________
Date_______
Student ID _________
Email Address: ______
Semester for which you are applying:
☐ Fall
☐ Spring
Year:
Please list the course(s) for which you have already been an Instructional Intern (II):
Please check the course(s) for which you are interested in being an II. Indicate the grade you received in the
course on the line next to the course title.
Please note: You must already have taken the course and received a grade of A- or higher and have an overall
GPA of 3.0 or higher.
* Indicates an FYE Course: Extra training and out-of-class activities are required.
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Fall
CSD 150 (online) ‐ Intro to CSD*
CSD 256 – Anat & Phys
CSD 257 – Normal Comm Dev
CSD 257 (online) ‐ Normal Comm Dev
CSD 262 – Phonetics
CSD 262 (online) ‐ Phonetics
CSD 311 – Lang Dev & Dis: Related Disciplines
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CSD 321 (online) ‐ Aural Rehabilitation
CSD 326 – Voice & Resonance Disorders
CSD 331 (online) – Dev Lang Disorders
CSD 352 (online) ‐ Fluency
CSD 353 (online) – Speech & Hear Science
CSD 358 – Phonological Disorders
CSD 370 – Clinical Procedures
CSD 373 – Basic Audiology
CSD 440 – Neuro Aspects of Comm
Spring
☐ CSD 150 – Intro to CSD
☐ CSD 256 (online) – Anat & Phys
☐ CSD 257 (online) – Normal Comm Dev
☐ CSD 258 – Normal Comm Dev – Lab
☐ CSD 262– Phonetics
☐ CSD 262 (online) – Phonetics
☐ CSD 321 – Aural Rehabilitation
☐ CSD 326 (online) – Voice & Resonance Dis
☐ CSD 331 – Developmental Language Dis
☐ CSD 352 – Fluency Disorders
☐ CSD 352 (online) – Fluency Disorders _____
☐ CSD 353 – Speech & Hearing Science
☐ CSD 353 – (online) – Speech & Hearing
Science _____
☐ CSD 358 (online) – Phonological Disorders
☐ CSD 370 – Clinical Procedures
☐ CSD 373 (online) ‐ Basic Audiology
☐ CSD 410 ‐ Communication Changes/Disorders of
the Older Adult
☐ CSD 411 – Facilitating Lang in Preschool Child
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Will you be enrolled in CSD 470 – Clinical Practicum during the semester for which you are applying?
☐ Yes
☐ No
Include a one-page essay that addresses the following points:
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Why you chose to have an Instructional Internship experience.
What you hope to gain from this Instructional Internship experience.
What skills and attributes you possess that will contribute to student learning.
Your essay should be specific to the course(s) for which you are applying. You should also note your availability
during the semester you are planning on being an II.
Essay: