GW Law

Field Placement Program
THE GEORGE WASHINGTON UNIVERSITY LAW SCHOOL
Supervisor Registration Form
Fall 2013

Due by  Friday, August 9, 2013

All placements must complete Section I. If your office is new to the Field Placement Program, please complete Section I and Section II in full.

Section I
Student's First Name:
 
Student's Last Name:
 
Student’s Email Address:
**Providing this email address will allow us to send a copy of this form to your student :
 
     
Salutation:
 
other:
 
Supervisor's First Name:
 
Supervisor's Last Name:
 
Supervisor's Title:
 
Agency's/Organization's Name:
 
Division:
 
Office/Section:
 
Supervisor’s Email Address:
 
Telephone No:
 
Fax No:
 
Mailing Address:
 
Street Address (if different):
 
 
Please upload a copy of your resume here:
 
 

If a resume is not available, please provide the URL address of an online biography that describes your professional experience. 

 
 

Students are required to be supervised by an on-site, licensed attorney with supervisory experience (i.e., professional experience supervising legal interns or junior attorneys). 

  I will work on-site, in the same office as my student:
 

I am a licensed attorney

  Please provide the name of the state(s) in which you are licensed to practice law.
 
  Please describe your professional experience supervising legal interns or junior attorneys
 
  Hourly commitment by student:
Has your office worked with the Field Placement Program before? Yes No
If yes, please list the most recent year in which you had an intern.
  I certify that this placement meets the following criteria:
 

Field Placement Requirements

  • The placement must be at a judicial, government, or non-profit (501(c)) organization.
  • Students must be engaged in substantive legal, legislative, or policy work.
  • Externships must begin no later than Monday 9/9/13 and must last at least eight weeks. 
  • Students must be directly supervised by an on-site, licensed attorney.
  • Students must work at least 80% of their hours on-site at their field placement under the supervision of their attorney-supervisor.
  • Students may not receive compensation for their externship work**.

    **This prohibition does not apply to negligible transportation or meal stipends. Stipends that are greater than the amount necessary to cover meal and  transportation costs will be deemed compensation and the student will not be permitted to receive credit for the externship. Yes No
  Please provide details regarding any funding/reimbursements, or other concerns/notes below:
 
  If your office has worked with The George Washington University Law School's Field Placement Program before, or the placement is judicial in nature, you DO NOT need to answer the questions that follow. If, however, your office is new to the Program, please provide the following information:
  Section II
  What is the nature of the work performed by your office?
 
  What substantive area(s) of law will your intern be exposed to over the course of the semester?
 
  What skills set(s) should an intern at your office expect to further develop?
 

Legal research

Legal writing

Other style of writing

Negotiating

Client interviews/counseling

Trial advocacy/litigation

Transactional law

Policy or Legislative work

Legal presentations/public speaking

Fact investigation

Other (please describe):

  How will you ensure adequate supervision and feedback?
 
  What office space will the student utilize and what equipment/services will (s)he be able to use?  (Please include information including the location of the intern’s desk in relation to your office, access to a computer, fax machine and telephone, available research tools, etc.)
 
  Is there a current orientation program or training manual that interns receive? If so, please describe below.
 
 

Have you supervised students before? No

If so, was it for the same externship opportunity as this one?

 
 

Supervisor

Date