Educational Leadership
Candidate Request Form for Intern Mentoring Supervisor
(Only required for Leadership programs
with Administrator Licensure)

Educational Leadership

Candidate Request Form for Intern Mentoring Supervisor

 Candidates for the M.Ed./ADM Licensure or Ed.S. Licensure - Educational Leadership Program:

The information below is required in order to begin your internship hours. Once you have provided these details and your listed site supervisor has accepted the role through our online confirmation process, the School of Education will be able to assign you to a faculty member as your mentor who will assist you in preparing your Internship Portfolio.  Please submit this form as soon as you have been admitted to the program.  Your internship hours will begin with your first course and continue through all courses in the plan of study (The Belhaven School of Education requires a minimum of 320 internship hours).

Please Note: Due to the required internship hours for licensure, those seeking Administrator Licensure cannot apply to the Educational Leadership program who are not currently employed at the school level.  Also, candidates seeking licensure cannot begin the program without a signed agreement from a school building administrator who will be willing to serve as their Mentoring Supervisor during their Internship over the course of their plan of study. 

Important:  DO NOT complete this form until you have contacted and followed your school/district policies, and you have permission to be involved in School Administrator Internship hours.  Please confirm that you have spoken to and received agreement from the supervisor you are identifying on this form.

*Intern Supervisors must be a current school administrator/principal holding a valid MS Five Year Administrator License or a Standard Career Level Administrator License. A person holding an Entry Level Administrator License cannot be recommended to serve as an Intern Supervisor.

Please Note: No candidate can begin the Educational Leadership program without an agreement with a building administrator to be an Intern mentoring Supervisor on file.

   Applicant Information


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 Internship Supervisor Information