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96 Unit Program
2014-2015
School of Intercultural Studies
STUDENT PRACTICUM PACKET
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Fuller Theological Seminary
135 N. Oakland Avenue
Pasadena, CA 91182
1. INTRODUCTION
Included in the MAICS curriculum is the opportunity to complete a cross-cultural
practicum that combines coursework with practical ministry. The practicum experience
challenges students to discern their calling, grow spiritually, and apply what they are
learning to a cross-cultural context. MAICS degree students are required to complete a
minimum of 24 units of missiology from the School of Intercultural Studies (SIS) prior to
enrolling in the Missiological Integration Practicum. We encourage students to complete
the practicum in the middle of their program to allow time for further theological and
missiological reflection through academic work after the practicum is complete. In this
document you will find information intended to help you plan, organize and complete
your practicum as well as the required forms to allow you to successfully register. Please
first contact your Vocational Advisor and/or the Director of Marketplace and Mission
Vocations in Call Discernment to discuss ideas, concerns or questions regarding your
practicum.
BASIC REQUIREMENTS
1. Your practicum site must provide an opportunity to work/serve in a context where at
least two cross-cultural elements are present. (i.e. working with people of a different
ethnicity than your own, different socio-economic group, generational diversity, etc.)
2. You must be able to complete 240 academic hours (8 units) in a minimum of 5 weeks
and in no more than two consecutive quarters (20 weeks). If you are completing the
practicum in two quarters, you must contact the academic advising office at the end of
your first quarter for information on registering for the next quarter.
3. You must work closely with the 1) your Vocational Advisor/Director of Marketplace
and Mission Vocations in Call Discernment and the SIS faculty practicum advisor Dr.
Roberta King (rking@fuller.edu), and 2) on site supervisor (s) to complete all of the
necessary paperwork, arrangements and assignments for your practicum within the
given timeframe.
STEPS FOR PLANNING
DUE DATES:
1. Request Practicum Packet*
2 quarters prior to placement
2. Submit Initial Proposal*
2 quarters prior to placement
3. Consult w/ Dr. King if needed*
2 quarters prior to placement
4. Complete Learning Agreement
1 quarter prior to placement
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5. Submit Completed Application*
5th week of the quarter prior to placement
6. Register for Practicum
8th week of the quarter prior to placement
7. Log into Moodle & Schedule Appt’s.* 1st week of the placement quarter
8. Complete Assignments/Evals.
10th week of the placement quarter
9. Debrief with Faculty Advisor
2nd week of the quarter following placement
*Please contact your Vocational Advisor and/or
the Director for Marketplace and Mission
Vocations in Call Discernment.
PRACTICUM PAPERWORK
 Initial Practicum Proposal
Step 2, p. 9-10

Application Packet
Check Lists (pp. 11-12)
Practicum Itinerary Form (p.13)
Learning Agreement (pp. 14-18)
Copy of Student Medical Insurance Card (p.11)
Copy of Round-Trip Tickets (if applicable, p.11)
Copy of Vaccination Records (p.11)
Proof of Medical Evacuation/ Repatriation Insurance* (p.11)
Copy of Passport and required visa(s)* (p. 12)
Release Form (p. 19-22)
Supervisor Guidelines (p.23)
Step 5, pp. 11-22

Practicum Evaluations
SIS Practicum Student Evaluation
SIS Practicum Supervisor Evaluation
Step 8, pp. 24-27

Lebanon Practicum Documents
Lebanon Orientation Packet
Lebanon Practicum Application
Contact Vocational Advisor
*International Practicum Only
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MAISCS PRACTICUM OVERVIEW
The following is an overview of the MAICS practicum requirements including the forms that
need to be submitted for approval in order to register. The documents are due by Friday of
the 5th week of the quarter prior to the practicum. (i.e. for summer practicum applications,
documents are due the 8th week of the Spring quarter).
Finding a Practicum Site
The practicum may be conducted either domestically or internationally in a distinctively
cross-cultural (ethnically or socio-economic) context, and will include supervised ministry,
ethnographic research with field notes, reading, writing, and optional language learning.
Each student is responsible for creating a Learning Agreement Contract with their on-site
supervisor and Practicum Faculty, choosing a location and organization with which to work,
and making his or her own arrangements for travel, housing, and food. Students are
encouraged to pursue a practicum focused on their degree’s emphasis and study at
Fuller. While researching possible practicum location sites, students should review the
potential risks of the country of destination in consideration on the U.S. State Department
website (www.travel.state.gov) and continue checking these updates until departure.
Students should additionally visit the CDC website (www.cdc.gov) and start scheduling any
required vaccinations.
Domestic vs. International Practicum
An international practicum requires 8-units of registration in one quarter and a minimum of
5-weeks of residence in the placement country and requires additional practicum
documentation detailed in the checklist. A Domestic practicum can be completed in one or
two quarters.
Selecting a Site Supervisor
The choice of on-site supervisor is a crucial element in the success of the practicum. Students
are encouraged to find a person in a position who is able to assist you through the process of
creating and implementing the practicum. The supervisor must be available to you
throughout the practicum for supervision, to provide insight and advice, and to help keep
you on track and focused. Additionally, the effective supervisor is someone from whom you
can learn and grow in the chosen ministry, and who has the ability to mentor you toward
increased cross-cultural competency and spiritual formation.
Registering for your Practicum Course
Before the student may register for this course, the student is responsible to (1) make
arrangements for a practicum site and on-site supervisor and (2) receive approval from the
faculty practicum advisor (Dr. King). Students are advised that this process often takes two
quarters (or more) to complete. Students must submit all required documents listed in the
checklist (either domestic or international) by the Friday of week 5 the quarter prior to
practicum placement. All documents should be submitted to your Vocational Advisor and
the Director of Marketplace and Mission Vocations in Call Discernment. Once your
documentation is approved, your Vocational Advisor will give you information on how to
register.
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Faculty Advisor
SIS faculty are available to mentor and guide students as they complete their practicum.
When the student receives their CRN to register for the course, they will be informed which
faculty member they will be enrolling with for the practicum. Once students register and are
assigned to a faculty member, they should post their Learning Agreement Contract in the
Moodle course for the practicum. 2. COURSE SYLLABUS
STUDENT LEARNING OUTCOMES
1. Students will integrate missiological theory from core, elective, and emphasis classes
with their practicum experience in order to think critically about their ministry in light
of broader global realities.
2. Students will deepen their understanding of the cultural context of ministry by
engaging and describing a specific context. This may include ethnographic research,
social or organizational analysis, and/or theological reflection.
3. Students will practice spiritual disciplines and self-care and reflect on the connections
between their faith, community and ministry in order to become more holistic
practitioners.
4. Students will develop skills and knowledge and networks of relationships to help in
discerning their vocational contribution within the mission of God globally.
REQUIRED READING (800 pages)
Students will develop a bibliography of 800 pages of reading. If help is needed, students
are encouraged to seek recommendations from their on-site supervisor, a mentor or a
professor. Their faculty advisor will approve the bibliography when complete. Please
develop a collection of reading that will address the following areas of (approximately 250
pages per category):
1. Christian Spirituality/Spiritual Formation (i.e. Dictionary of Christian Spirituality)
2. Area of the World/Cultural Context (i.e. Operation World, p. 150-345)
3. Ministry/Work Specific (i.e. Walking With the Poor)
PREREQUISITES
The student is required to complete 24 units of missiology before he/she can register for
the practicum
RELATIONSHIP TO CURRICULUM
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Meets the 8-unit practicum requirement for the Master of Arts in Intercultural Studies
(MAICS) degree.
PRACTICUM RESPONSIBILITIES
An 8-unit practicum requires 240 completed academic hours. International practicum
requires 8- units of registration in one quarter and a minimum of 5 weeks of international
placement. These responsibilities and requirements are further outlined in the Learning
Agreement.
PRACTICUM RESPONSIBILITIES - Continued
Responsibilities
Weekly meetings with on-site
supervisor
Requirements
1 hour a week required.
1 hour of meeting time
= 1 academic hour.
Supervised ministry
1 hour of ministry
= 1 academic hour.
Cultural Focus (for example: language
learning, culture observation, etc.)
1 hour of language learning = 1 academic hour.
Reading (from bibliography)
25 pages of reading
= 1 academic hour.
Writing Assignments (journaling &
papers)
1 page of writing
= 1 academic hour.
Debrief with Practicum Faculty
1 hour of consultation
= 1 academic hour.
ASSIGNMENTS
A passing grade will require satisfactory completion of the practicum as specified in the
individual Learning Agreement and satisfactory completion of the following assignments
or alternate assignments in consultation with the faculty advisor:
Learning Agreement Contract, 5%
Due Week 1
Students will complete a Learning Agreement Contract with their on-site supervisor and
Practicum Faculty. This is to be emailed to the Practicum Faculty member by week eight
of the quarter prior to the practicum. The approved and final version of the Learning
Agreement Contract should be uploaded to Moodle during week one of the quarter of the
practicum.
Cultural Descriptive Paper or Case Study Paper, 30%
Due Week 7
Students will write a cultural descriptive paper or a case study paper (1,000-1,500 words)
of the context where they are completing their practicum. The student’s readings should
be reflected in this paper.
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Journal, 20%
Due Week 10
Students will journal weekly reflecting on their progress in their personal development
goals listed in the Learning Agreement Contract for cross-cultural immersion,
missiological integration, spiritual formation, vocational discernment, and self-care. The
student’s reflections on their readings should be reflected in this paper. The final journal
will be due during week 10.
Final Integration Paper, 30%
Due Week 10
Students will write a final integration paper that utilizes a minimum of three missiological
theories or concepts to analyze their practicum experiences (1,750 to 2,000 words). The
student’s readings should be reflected in this paper. Students registering for a 4-unit
practicum will work with the Practicum Faculty to determine how their assignments
should be submitted.
Evaluations, 5%
Due Week 10
Students will upload completed Student Practicum Evaluation and on-site supervisor’s
Practicum Evaluation forms to Moodle during Week 10 .
Faculty Consultations, 10%
Due Week 10
Students will talk with the practicum faculty a minimum of two times over the quarter to
debrief their practicum experience. Student must schedule the two meeting during week
1 of the quarter.
GRADING
It is essential that all assignments be completed by the due date. The following scale will
be used to determined the grade for each assignment and if the final grade is a pass or
fail:
GRADE
MARK
A
96-100
A-
92-95
B+
87-91
DESCRIPTION
Outstanding:
The level of reflection, research, thinking, and communication are
outstanding. You critically evaluate the relevant theories, integrate it
in the analysis of your selected topic or case, and show how it is
applicable in the context you have chosen. Additionally, you
synthesize models to create new understandings and/or theory. This
is NOT a common grade.
Superior:
The level of reflection, research, thinking, and communication are
superior. You understand and interact with the theories, integrate it
with your topic, and have shown how it is applicable in the context
you have chosen.
Very good:
The level of reflection, research, thinking, and communication are
satisfactory. You appear to understand the theories, read the assigned
literature, and have made progress in showing how it is applicable in
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the context you have chosen, though your work could be stronger in
both areas.
B
82-86
B-
77-81
C+
72-76
C
or
below
71
or below
Satisfactory:
The level of research, thinking, & communication are satisfactory. You
appear to have read the assigned literature and have made progress
in showing how it is applicable in the context you have chosen,
though your work could be stronger in both areas.
Acceptable but average at best:
The level of reflection, research, thinking, and communication are
acceptable. It appears you understand the reading and have made a
start in showing how it is applicable in the context you have chosen.
Acceptable but definitely below average:
The level of reflection, research, thinking, and communication are
barely acceptable. You have read some of the theories and have
started to consider how it is applicable in the context you have
chosen, but you have not demonstrated either clearly.
Not acceptable:
Depending on what I see, I may assume you tried, but it is not
graduate level.
ATTENDANCE POLICY
Students are expected to fulfill all of the requirements for the practicum, including on-site
supervisory meetings. Should the student or on-site supervisor miss a meeting due to illness,
vacation, or emergency, the meeting should be rescheduled. In the event that a student is
unable to complete all of the required practicum supervised ministry hours agreed upon in
the Learning Agreement Contract, the student must work with the practicum faculty member
to determine how to make up those hours.
INCOMPLETE POLICY
If a student is unable to complete an assignment because of a serious problem that was
unforeseen and unavoidable, the student may petition for an Incomplete. Obtain this form
from the Registrar or download it from the Registrar’s section under the “Current Students”
tab on Fuller’s website. Please see the Incomplete Request Form for the criteria of
circumstances that would qualify for an Incomplete.
OTHER IMPORTANT GUIDELINES AND PROCEDURES
 Save copies of completed documents prior to uploading. You will need the Learning
Agreement for reference throughout the practicum.
 If students wish to change any aspect of their Learning Agreement after it is approved,
including but not limited to the on-site supervisor or ministry tasks, the student must
contact Practicum Faculty to request approval. If the practicum is not meeting the goals
and responsibilities articulated in the Learning Agreement Contract, please contact the
Practicum Faculty immediately.
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ACADEMIC INTEGRITY COMMITMENT
At the beginning of this course we, as faculty and students, reaffirm our commitment to be
beyond reproach in our academic work as a reflection of Christian character. We commit to
honesty in all aspects of our work. We seek to establish a community, which values serious
intellectual engagement and personal faithfulness more highly than grades, degrees, or
publications. Students are expected to review and understand the commitments to academic
integrity as printed in the Student Handbook and the Seminary catalogue. Some infractions
can be addressed by personal confrontation and corrective counsel. The following violations
of these commitments will be firmly addressed formally:
Submitting the same work in whole or in part in more than one course without the permission of the
professor(s); submitting as one’s own work paper(s) obtained from another source; plagiarism, i.e.,
large and/or multiple unattributed quotations or paraphrases of ideas from published or unpublished
sources; unpermitted collaboration in preparing assignments; cheating on exams by any means; aiding
another student on papers and tests in violation of these commitments.
Any of these violations will result in a failing grade on the assignment and possibly in the
course, and will be reported to the Academic Integrity Group which may impose further
sanctions in accordance with the Academic Integrity Policy. Evidence of repeated violations
will result in a formal disciplinary process. (For the full statement on Academic Integrity see
The Student Handbook 2001-2002 pages 58-60.) Academic Integrity Group Chair: aigchair@dept.fuller.edu
3. PRACTICUM PAPER WORK
INITIAL PRACTICUM PROPOSAL
Optional - Due two quarters prior to placement
For students needing additional help selecting a site
This document is designed to initiate the conversation between you (the student) and your Vocational
Advisor or the Director of Marketplace and Mission Vocations, as well as prompt you to think critically
about your site, ministry and scholarship during the entirety of MI516
STUDENT
NAME:
STUDENT G#
DESIRED QUARTER FOR PRACTICUM PLACEMENT:
CHECK WHAT BEST DESCRIBES YOUR CURRENT STATUS:
“I have identified my site”
“I have a few ideas about my site”
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“I need help figuring out my site”
IF YOU ALREADY HAVE A SITE, TELL ME ABOUT IT…
a. Name of Site:
b. Location:
c. Will you be staying on site?
Y
N
d. Name and Title of Site Supervisor:
e. What will you be doing?
f. What are at least two cross-cultural elements in this project? 1.
2.
g. Duration of the project:
h. List all the reasons why you feel this particular site/project is the best choice for your
practicum?
IF YOU HAVE SOME IDEAS, TELL ME ABOUT THEM:
Idea 1:
Idea 2:
Idea 3:
IF YOU NEED SOME HELP, TELL ME ABOUT - YOU:
What are your strengths?
What are your gifts?
What do you feel like God has called you to?
What past ministry experience do you have?
What do you want to do after you graduate?
What are some areas of your faith, knowledge,
service you want to strengthen?
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What types of scenarios challenge you?
What types of ministry experience would bolster your academic career and missiological
understanding?
WHAT QUESTIONS DO YOU HAVE FOR ME AT THIS TIME?
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CHECKLISTS
Your packet will consist of items in EITHER the Domestic OR International Checklist,
depending on your site. Your packet is due by Friday week 5 of the quarter prior to
placement, unless otherwise specified.
DOMESTIC CHECKLIST
Learning Agreement (with 800pg Bibliography, and 240 Academic Hours)
Practicum Itinerary
Photocopy of your Current Vaccination Record
Consult the Centers for Disease Control and Prevention for a list of current U.S. based
outbreaks to determine if immunizations specific to your destination are needed.
(http://www.cdc.gov/outbreaks/index.html) You must receive all required vaccinations listed by
the CDC. Keep in mind that some vaccinations require multiple shots and may take over a
month to complete.
Copy of your Student Medical Insurance Card
During the quarter in which you register your practicum, you must continue to meet the minimum
student health insurance requirements set by Fuller for medical insurance. This is done by
purchasing Fuller’s student insurance (Delos or Kaiser Permanente), or by meeting the standard
requirements to waive the coverage. Contact Fuller’s Student Health Insurance office for details at
626-584-5438.
Copy of Round-trip Airline Tickets (If applicable)
The airline or travel company you select should send you an electronic confirmation of your
itinerary; please save this as a PDF and attach that to your email submittal.
Signed Assumption of Risk and Release from Liability (original hard copy)
Since you have independently selected your practicum site and supervisor, and voluntarily
chosen to participate in this particular experience at this time, the seminary requires that you
sign and date an Assumption of Risk and Release from Liability. This document must be dated
and personally signed by you.
INTERNATIONAL CHECKLIST
Learning Agreement (with 800pg Bibliography, and 240 Academic Hours)
Practicum Itinerary
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Photocopy of your Current Vaccination Record
Consult the Centers for Disease Control and Prevention for a list of recommended and required
immunizations specific to your country. (http://wwwnc.cdc.gov/travel/default.aspx) You must
receive all required vaccinations listed by the CDC. Keep in mind that some vaccinations
require multiple shots and may take over a month to complete.
Photocopy of your Student Medical Insurance Card
During the quarter in which you register your practicum, you must continue to meet the
minimum student health insurance requirements set by Fuller for medical insurance. This is
done by purchasing Fuller’s student insurance (Delos or Kaiser Permanente), or by meeting the
standard requirements to waive the coverage. Contact Fuller’s Student Health Insurance office
for details at 626-584-5438.
Proof of Medical Evacuation/Repatriation Insurance
If you do not have medical evacuation/repatriation insurance through Fuller*, you are required
to purchase medical evacuation and repatriation insurance through HTH Worldwide or a
company with approved comparable coverage. HTH Worldwide should send you an electronic
confirmation of your coverage; please save this as a PDF and attach that to your email
submittal. Insurance can easily be purchased through HTH Worldwide at
https://www.hthstudents.com/ge.cfm?ac=GHE-16248.
*Please read the international release form on page 20 for more information.
Copy of round-trip airline tickets
Copies of passport and any required visa(s)
Hard copies are suggested for passport information security purposes. Your passport must be
valid for at least 6 months (preferably one year) after the date of entry to your destination.
Signed Assumption of Risk and Release from Liability (original hard copy)
Since you have independently selected your practicum site and supervisor, and voluntarily
chosen to participate in this particular experience at this time, the seminary requires that you
sign and date an Assumption of Risk and Release from Liability. This document must be dated
and personally signed by you.
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PRACTICUM ITINERARY FORM (For Domestic & International)
Name
Email
Phone
Name:
Email:
Phone:
Name:
Email:
Phone:
Emergency Contact #1
Emergency Contact #2
Destination(s)
Departure Date
Days at Destination
Airline(s)
Organization Name
and Address
Name:
Emergency Contact
at Destination
Is this person your on-site supervisor?
yes
Address:
Phone:
no
Closest U.S. Embassy
What is the best way to contact you during your practicum? Check all that apply.
My email
My phone
Supervisor Email
Supervisor Phone
- Please make additional copies for each destination at which you will be residing.
- Distribute copies of this itinerary to your family members and/or emergency contacts prior to
departure.
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LEARNING AGREEMENT
Prior to completing your Learning Agreement you should speak with your On-site
supervisor to get an idea of what type of ministry will be possible for you to participate in
and what role you will play. This document cannot be filled out without discussing these
items in detail with your On-site supervisor.
Student Name:
G#:
Email:
Day/Cell Phone:
Supervisor Name:
Organization:
Supervisor Email:
Supervisor Phone:
Supervisor Name (2nd Supervisor if Applicable):
Organization:
Supervisor Email:
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Supervisor Phone:
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I. Personal Development Goals (Completed by Student)
For each item, identify (1) your GOALS (what you want to accomplish) and
(2) your OBJECTIVES (specific steps on how you will accomplish your goal).
If you are completing your practicum over 2 quarters, please articulate what you will be
doing in each quarter.
A. Cross-Cultural Immersion: In this goal, focus on what you want to learn about the
local culture, language, social and cultural norms, etc.
1. Goals:
2. Objectives:
B. Missiological Integration: In this goal, focus on integrating your missiological
academic coursework into your practicum experience including ways you would like
to minister the gospel in word and deed.
1. Goals:
2. Objectives:
C. Spiritual Formation: Describe the spiritual disciplines you will exercise to help you
grow spiritually during the practicum. Be ready to reflect on this goal in your Spiritual
Journal assignment.
A. Spiritual Disciplines
1. Goals:
2. Objectives:
B. Building and Interacting with your Prayer Team
1. Goals:
2. Objectives:
D. Vocational Discernment: In this goal, focus on taking steps toward discerning your
gifts, calling, and future vocation. Describe how you can gain practical experiences
that will aid in discerning your vocation.
1. Goals:
2. Objectives:
E. Self-Care: Describe how you plan to exercise self-care as part of holistic ministry in a
cross-cultural context. Choose a personal self-care goal that will enable you to live
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with more balance in all areas of life. Consider areas such as rest, recreation, family
time, exercise, Sabbath, and time management.
1. Goals:
2. Objectives:
II. Practicum Bibliography (Completed by Student):
Students will develop a bibliography of 800 pages of reading. A full biography following
the Chicago Manual of Style (15B) is required.
If help is needed, students are encouraged to seek recommendations from their on-site
supervisor, a mentor or a professor. Their faculty advisor will approve the bibliography
when complete. Please develop a collection of reading that will address the following
areas of (approximately 250 pages per category):
1. Christian Spirituality/Spiritual Formation (i.e. Dictionary of Christian Spirituality)
2. Area of the World/Cultural Context (i.e. Operation World, p. 150-345)
3. Ministry/Work Specific (i.e. Walking With the Poor)
List the books/articles you have chosen below. Include the number of pages that will be
read from each source.
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III. Practicum Responsibilities (Completed by Student and on-site supervisor)
Fill in each category with enough pertinent information, which communicates what you
will be involved in during your practicum. An 8-unit practicum is 240 academic hours
and a 4-unit practicum requires 120 academic hours. An international practicum requires
a minimum of 5-weeks of international placement. A domestic 4-unit practicum can
reduce the reading to 400 pages and writing to 1,375-1,750 words. For each
responsibility describe the specific tasks and time allocation (# of hours/week) proposed
for your practicum.
To Be Completed by Student and
Description
Supervisor
Supervision Meetings
(1 hour a week required)
Supervised Ministry (Describe your
plan for supervision of practicum
responsibilities)
Other (for example, Language
Learning)
Reading (Students will develop a
bibliography in conversation with their
Practicum Faculty advisor and On-site
supervisor consisting of 800 pages of
reading which equals 32 hours.)
Writing (Weekly Journal, Cultural
Descriptive Paper or Case Study, and
Final Integration Paper - 2,750-3,500
words equals 11-14 hours.)
Debrief with Practicum Faculty
(Students will talk with the practicum
faculty a minimum of two times over
the quarter to debrief their practicum
experience.)
Total Hours (120 hours for 4-units; 240 hours for 8-units)
Hours
IV. Supervision Agreement: (SUPERVISOR AND STUDENT: READ, ACKNOWLEDGE,
AND AGREE TO THE FOLLOWING). When you email the final draft of this document to
the Director of Marketplace and Mission Vocations, Vocational Advisor and Faculty
Advisor, both you and your on-site supervisor are acknowledging and confirming that you
have read, discussed, and are in agreement with the terms of this Learning Agreement,
which are summarized as follows:
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 The supervisor and student will hold weekly hour-long supervisory one-on-one meetings for
the purposes of mentoring, missiological reflection, evaluation, and prayer.
 The supervisor and student agree to follow the practicum as outlined in this Learning
Agreement with the understanding that the terms may be adjusted by mutual consent and
with the approval of the Practicum Faculty.
 The supervisor and student understand that if problems develop, either or both will
contact Roberta King (rking@fuller.edu), School of Intercultural Studies Deans office at
(626) 584-5265 or Call Discernment immediately at 001 or 0001 +(626) 584-5387 or email
vocation@fuller.edu
 The supervisor and student understand that this agreement may be terminated at any time
for any reason by the supervisor or the student or the Practicum Faculty. If this is done, all
parties must be notified immediately.
 The supervisor will be responsible for providing supervision of the student during the
course of his/her experience at the practicum site. (The Supervisor Guidelines are hereby
incorporated by reference).
School of Intercultural Studies, Fuller Theological Seminary
20
TERM:
TYPE:
UNITS:
G#
NAME:
Domestic: RELEASE FROM LIABILITY, ASSUMPTION OF THE RISK, AND HOLD
HARMLESS AGREEMENT (“Release”)
[Instructions: This must be signed with blue ink; electronic signatures will not be accepted.}
I, the undersigned, hereby acknowledge that I have personally researched and read about the
dangers and risks which I am voluntarily assuming by choosing to have this particular
cross-cultural practicum experience and travel within the United States at this time. I am
aware of and understand the risks and dangers of this domestic cross-cultural experience
and travel to, in, and about the city (ies) and/or rural areas I have personally selected,
including but not limited to any dangers to my own health and personal safety posed by
terrorism, infectious diseases, natural disasters, crime, civil unrest and violence, as well as
road travel and ground transportation. I hereby voluntarily and knowingly assume these
risks. I understand, acknowledge, and agree that Fuller Theological Seminary is not
responsible to protect me from risks and dangers, known and/or unknown.
I understand, acknowledge, and agree that Fuller Theological Seminary assumes no
responsibility or liability, in whole or in part, for any sickness, disease, injuries (including
death), losses, damages, weather, strikes, acts of God, quarantine, civil unrest, public
health risks, criminal activity, terrorism, accident, mechanical defects, failure or
negligence of any nature howsoever caused, which I may experience during my travel to,
from, in, at or around my voluntarily chosen practicum site(s).
I further understand, acknowledge, and agree that Fuller Theological Seminary provides no
insurance coverage of any kind or nature for me, other than its standard student health
insurance. I hereby represent and warrant that I am and will be covered throughout my
domestic cross-cultural study experience and travel by a policy of comprehensive health
insurance through my standard student health insurance or approved comparable
coverage for each academic quarter during which my cross-cultural experience and travel
occur.
I further understand, acknowledge, and agree that Fuller Theological Seminary has no
responsibility to protect me in the event of civil unrest or war and that the seminary has
no responsibility to pay any demand(s) resulting from extortion, kidnapping, and/or
threats of harm to me.
I hereby release and agree to hold harmless Fuller Theological Seminary, including the
School of Intercultural Studies, and its trustees, officers, faculty and other employees,
independent contractors, and agents of all responsibility and liability, excepting only
gross negligence, for any injuries (including death), illness, claims, damages, charges, bills
and/or expenses I may concur while I participate in this domestic cross-cultural
experience and travel, which I have chosen to experience at this time.
School of Intercultural Studies, Fuller Theological Seminary
21
TERM:
TYPE:
UNITS:
G#
NAME:
I hereby also acknowledge and agree that this RELEASE FROM LIABILITY, ASSUMPTION
OF THE RISK, AND HOLD HARMLESS AGREEMENT (“Release”) shall be interpreted
in accordance with the laws of the State of California, United States of America.
I hereby acknowledge that I have read and understood this RELEASE FROM LIABILITY,
ASSUMPTION OF THE RISK, AND HOLD HARMLESS AGREEMENT (“Release”). I do
for myself, my heirs, and my personal representative(s) hereby agree to abide by each of
the terms and conditions of this Release. I understand that an attorney prepared this
Release for Fuller Theological Seminary and that it is a legally binding document. I have
had ample opportunity to review this RELEASE FROM LIABILITY, ASSUMPTION OF
THE RISK, AND HOLD HARMLESS AGREEMENT (“Release”).
[Instructions: This must be signed with blue ink; electronic signatures will not be accepted.}
Print Name: ____________________ Signature: _____________________ Date:______________
School of Intercultural Studies, Fuller Theological Seminary
22
TERM:
TYPE:
UNITS:
G#
NAME:
International: RELEASE FROM LIABILITY, ASSUMPTION OF THE RISK, AND HOLD
HARMLESS AGREEMENT (“Release”)
[Instructions: This must be signed with blue ink; electronic signatures will not be accepted.}
I, the undersigned, hereby acknowledge that I have personally researched and read about the
dangers and risks which I am voluntarily assuming by choosing to have this particular
international cross-cultural practicum experience and travel at this time. I am aware of
and understand the risks and dangers of this international cross-cultural experience and
travel to, in, and about the country(ies) I have personally selected, including but not
limited to any dangers to my own health and personal safety posed by terrorism,
infectious diseases, natural disasters, crime, civil unrest and violence, as well as road
travel and ground transportation. I hereby voluntarily and knowingly assume these risks.
I understand, acknowledge, and agree that Fuller Theological Seminary is not responsible
to protect me from risks and dangers, known and/or unknown.
I understand, acknowledge, and agree that Fuller Theological Seminary assumes no
responsibility or liability, in whole or in part, for any sickness, disease, injuries (including
death), losses, damages, weather, strikes, acts of God, quarantine, civil unrest, public
health risks, criminal activity, terrorism, accident, mechanical defects, failure or
negligence of any nature howsoever caused, which I may experience during my travel to,
from, in, at or around my voluntarily chosen practicum site(s).
I hereby represent and warrant that I am and will be covered throughout my international
cross-cultural practicum experience and travel by a policy of:
1) Comprehensive medical evacuation/repatriation insurance as well as by
2) Fuller Theological Seminary’s standard student health insurance or an approved
comparable insurance of my choice for each quarter during which my international
cross-cultural experience and travel occur.
School of Intercultural Studies, Fuller Theological Seminary
23
TERM:
TYPE:
UNITS:
G#
NAME:
PLEASE NOTE: If you purchase student health insurance through Fuller (i.e. Kaiser or
Health Net), you are automatically enrolled in Global Emergency Services and do not
need an additional medical evacuation/repatriation insurance.
If you do not purchase your health insurance through Fuller, all Fuller students
participating in an international travel experience are eligible for the Fuller group plan
offered by HTH Worldwide. You can access the Fuller group plan through the
following link: https://www.hthstudents.com/ge.cfm?ac=GHE-16248. Or, you may
purchase comparable coverage from another company of your choice. (Verification of
the additional medical evacuation/repatriation coverage must be received with the
completed practicum application during the 5th week of the quarter prior to
placement.)
I further understand, acknowledge, and agree that Fuller Theological Seminary has no
responsibility to protect me in the event of war or civil unrest and that the seminary has
no responsibility to pay any demand(s) resulting from extortion, kidnapping, and/or
threats of harm to me.
I hereby release and agree to hold harmless Fuller Theological Seminary, including the
School of Intercultural Studies, and its trustees, officers, faculty and other employees,
independent contractors, and agents of all responsibility and liability, excepting only
gross negligence, for any injuries (including death), illness, claims, damages, charges, bills
and/or expenses I may concur while I participate in this international cross-cultural
experience and travel, which I have chosen to experience at this time.
I hereby also acknowledge and agree that this RELEASE FROM LIABILITY, ASSUMPTION
OF THE RISK, AND HOLD HARMLESS AGREEMENT (“Release”) shall be interpreted
in accordance with the laws of the State of California, United States of America.
I hereby acknowledge that I have read and understood this RELEASE FROM LIABILITY,
ASSUMPTION OF THE RISK, AND HOLD HARMLESS AGREEMENT (“Release”). I do
for myself, my heirs, and my personal representative(s) hereby agree to abide by each of
the terms and conditions of this Release. I understand that an attorney prepared this
Release for Fuller Theological Seminary and that it is a legally binding document. I have
had ample opportunity to review this RELEASE FROM LIABILITY, ASSUMPTION OF
THE RISK, AND HOLD HARMLESS AGREEMENT (“Release”).
[Instructions: This must be signed with blue ink; electronic signatures will not be accepted.}
Print Name: ____________________ Signature: _____________________ Date:______________
School of Intercultural Studies, Fuller Theological Seminary
24
TERM:
TYPE:
UNITS:
G#
NAME:
4. SUPERVISOR GUIDELINES
All students pursuing a Master’s degree in Intercultural Studies (MAICS) are required to
complete 8-units of practicum that integrates academic coursework with praxis. The
practicum may be conducted either domestically or internationally in a distinctively
cross-cultural (ethnically or socio-economic) context, and include supervised ministry,
online forums, ethnographic research with field notes, reading, writing, and optional
language learning. Students are encouraged to pursue a practicum focused on their
degree’s emphasis and study at Fuller. The School of Intercultural Studies offers courses
concentrating in the following areas: international/community development, children at
risk, church as mission, global Christian worship, Islamic studies, anthropology, and
leadership.
Each student is responsible for crafting a Learning Agreement with their On-site
supervisor and faculty advisor to ensure all parties are aware of and involved in the
student’s goals, objectives and learning experience.
Responsibilities
1. Student - Each Fuller student is responsible for:
School of Intercultural Studies, Fuller Theological Seminary
25
TERM:
TYPE:
●
●
●
●
●
●
●
UNITS:
G#
NAME:
Organizing practicum plan/site
Travel arrangements
Housing
Food
Travel insurance
Completing academic coursework (hours) & assignments
Selecting an On-site supervisor
2. Host Organization - The following are requirements of the host organization:
●
●
Suggestions for a ministry that the student may assist with and/or observe.
Orientation to the culture and/or language of the host country, as needed.
3. On-site supervisor - The following are responsibilities of the On-site supervisor:
●
●
●
●
●
●
●
Regular meetings with the student (at least one hour per week) for debriefing,
theological and missiological reflection, prayer, planning, and evaluation.
Provide an environment that is supportive and challenging for the student, and
encouraging the student to immerse him/herself in the local community.
Present opportunities for cross-cultural immersion which may include:
participation in a local church, living with a local family, attending festivals, eating
meals with people, etc.
Has lived in the current location (or country) a minimum of 2 years.
Has worked in the current organization a minimum of 1 year.
Has received formal or informal training in theology and/or missions. This may
include seminary or Bible school education, missions training, conferences,
seminars, or other forms of learning missiological integration.
If an emergency or problems develop, contact Roberta King (rking@fuller.edu), SIS
Dean’s office (626) 584-5265 or the Call Discernment at 001 or 0001 +(626) 584-5387
or vocations@fuller.edu.
School of Intercultural Studies, Fuller Theological Seminary
26
STUDENT EVALUATION
MI516 Missiological Integration Practicum
Instructions: Upload your completed evaluation to the online Moodle course on Friday of Week Ten.
Keep a copy for your records.
Student Name:
Cell Phone:
Academic Quarter:
On-site supervisor Name:
Supervisor Email:
2nd Supervisor (if applicable):
2nd Supervisor Email:
The purpose of the evaluation process is to provide an opportunity for you and your
supervisor to reflect on what you have learned and how you have been formed during your
practicum.
Section One: Report on the Terms of your Learning Agreement Provide a report on how you
have fulfilled the Learning Agreement during this quarter. Relate your responses to the
specific goals and objectives established in your Learning Agreement.
I.
Personal development goals
Describe in detail how you met your goals. Comment on your achievements,
challenges, and new insights in regard to your goals. Please refer to your Learning
Agreement.
A. Cross-cultural Immersion
B. Missiological Integration
C. Spiritual Formation
D. Vocational Discernment
E. Self-Care
II.
Practicum Responsibilities
A. Ministry Time
1. Reflect on how your time was spent at the practicum site and highlight the
ways you expected and didn’t expect your time to be spent. How did the
context’s relationship to time affect you’re your ability to relate to the people at
your practicum site, and your assignments? Were the hours as listed in your
Learning Agreement realistic to what you experienced?
27
2. How well did you use your cross-cultural tools in the cultural context and in
your particular ministry? Please include insights gained from your
ethnographic research (interviews, surveys, participant observation, etc.) and
discussions with your supervisor about this topic.
B. Language Learning (not a required area within the Learning Agreement, answer if
possible)
1. If you were engaged with language learning, were you able to develop
relationships with people through the use of language?
2. What did you understand about the culture through your language learning (if
applicable)?
Section Two: For this section, discuss both Section One (above) and the Supervisor Evaluation with
your on-site supervisor. Then record new insights that have emerged as a result of
your discussion.
I. Supervision Agreement
A. Please describe the quality and frequency of the meetings with your supervisor
during your practicum.
B. What specific theological and missiological issues have you addressed with your
supervisor?
C. How were you formed for ministry by your supervisor’s mentoring (i.e. guiding
you toward future vocational development, spiritual development, cultural
awareness, etc.)?
II.
Case Study
A. What have you learned about missiological reflection and its connection to ministry
and becoming a more holistic practitioner? What have you learned about its role in
personal spiritual formation and personal faith?
B. What are ways you envision using missiological reflection in your future ministry or
organization?
C. What was the most helpful and least helpful part of the online forums?
D. In what ways did the practicum facilitator help or hinder your experience?
Section Three: Record the date on which you and your on-site supervisor discussed your evaluations.
I. Discussion of Student and Supervisor Evaluations
28
A. Discuss both the Student (Section One) and Supervisor Evaluations with your
supervisor.
B. Describe thoughts and insights that emerged as a result of your discussion.
II. Record Date of Discussion of Student and Supervisor Evaluations
I have discussed the Student and Supervisor Evaluations with my supervisor on
_________________ (date).
SUPERVISOR EVALUATION
MI516 Missiological Integration Practicum
The School of Intercultural Studies highly values your contribution to our students’ practicum. We
encourage you to share your honest assessment and reflections on each student’s formation as a person
and as a cross-cultural practitioner. Please complete each section below. Please keep a copy of this
evaluation for your records.
Student Name:
Academic Quarter:
Supervisor Name:
Supervisor Email:
2nd Supervisor Name (if applicable):
2nd Supervisor Email:
Please respond to the questions in Sections I, II and III, and evaluate how well the student has achieved
the goals stated in the Learning Agreement, as provided by the student. Once you have completed the
evaluation, please discuss it with the student.
I.
Terms of the Learning Agreement
A. Practicum Outcome (Learning Agreement, Sections I & III)
Please assess how well the student achieved his/her stated goals, and the effectiveness of the
student’s ministry engagement in light of the needs and context of the practicum site.
B. Practicum Responsibilities (Learning Agreement, Section III)
Please assess how well the student has completed each of the identified responsibilities.
II.
Student Development
A. Interpersonal Skills
29
Please assess the student’s interpersonal skills while working with others during the practicum.
You may wish to discuss communication skills, ability to work well with others, conflict
management skills, etc.
B. Cross-Cultural Adjustment
How did the student adapt or adjust to the cross-cultural context? How well was the student
received by the local people? Were there any issues regarding the student’s interactions?
C. Time Management
Please discuss the student’s ability to use time effectively to meet responsibilities and goals, and
to set appropriate boundaries to seek proper self-care.
III.
Supervision
A. Weekly Meetings - Describe the frequency and length of your supervisory meetings.
B. Mentoring and Formation of the Student - Describe the various ways in which you guided
the student toward further growth within the context of this practicum. For example,
discussions on the student’s personal, vocational, and cross-cultural development.
What have you observed about the student’s ability to integrate personal faith into this
practicum?
C. Reflection and Prayer
What issues have you discussed with the student during your weekly meetings (for example,
missiological, theological, vocational, spiritual, etc.)
Please comment on the student’s ability to reflect and think deeply within the cross-cultural
environment. (If applicable, discuss how well the student integrated missiology and ministry.)
Was the student willing to engage and be transformed by the missiological reflection process?
IV. Date of Discussion of Supervisor Evaluation
I __________________________, the site supervisor, have discussed the topics covered in this
(your name - PRINTED)
evaluation and the topics in Section One of _________________________’s evaluation on
(the student’s name)
_______________________.
(date evaluation was discussed)
_______________________
(your signature)
Please email the completed Supervisor Evaluation to the student as a PDF file. The student will upload
the evaluation to Moodle for the faculty to review.
30