B Loyota Universiry Maryann Educational Technology Internship Approval Form Instructions for Student: 1. Fill out the student information below and attach your Educational Technology Internship Proposal. Any project within a school or professional setting must have the approval of an administrator or supervisor within that school or business. 2. Bring this form with the attached proposal to the administrator or supervisor, and have him/her complete and sign the School Administrator or Supervisor Approval section. 3. Register for ET691 Educational Technology Internship for the semester in which you will begin your internship. Consult your advisor for the appropriate section number. 4. Sign this form and submit it (along with the attached proposal) to your Internship Supervisor for signature and cataloging. Student Information Name Charmaine Auth Home Phone 443-247-6923 cat phone 03/- 5I2- 9943 Semester(s) for Intership__ Fal] 201% School Administrator or Supervisor Approval Name Karine. Cashes rwe_Hiacipal Work Phone Alo~ 631- Sl Email Address Koustin 2@ Z@beps. one School/Business Name New Thon _EVernentowsy B T have read the attached proposal and agree to allow this Semen to take place. Student and Advisor Signatures of Approval Student's sienaure Cnoungue Atl vate_1O/)) [18 Internship Supervisor's Signature