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Appendix A: Application for Internship

0. LAMAR UNIVERSITY

Lamar University - M.Ed. in Educational Technology Leadership

Application for Internship

Directions:
• After completing the application, post to your course wiki/e-portfolio. Print the completed document and ask your site mentor
to read and sign.
• Keep a hard copy for your records. Scan and then email to:kayabernathy@gmail.com. Be sure to place in the subject line:
Internship Application _lastname, flrstname

Name 1 S_a_n_d_ra_L_e_a_A_I_Ie_n-----l Student ID I_L2_0_2_5_98_9_3 _

Cohort Group 13
----------

Address @734 Woodford, Baytown, TX 77521

Email sallen74@comcast.net Home Phone @81-421-1873

Work Phone 1 281-420-4560 x120 (school year) Cell Phone 1832-414-67751

Intern Signature: 1~d:4:1 a.a:;v Date


Please indicate your proposed location.

School 1 Baytown Junior District 1Goose Creek CISDI

Address 17707 Bayway Dr., Baytown, TX 775201

Site Mentor Steve Koester Phone 1 281-420-48001

Email sekoester

Site Mentor Signature

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