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The Office of Field Education

LEARNING - SERVING COVENANT

(due 3 weeks into term)

Name of Student ____________________________________________________________

Name of Church/Institution ____________________________________________________

City ________________________________ State ___________________________

Name of Pastor/Supervisor ____________________________________________________

Name of Lay Training Committee Chairperson ____________________________________

Assignment Beginning Date: ______________ Ending Date: ______________

Interns Previous Field Ed Experience:

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Supervisory Conference Plan (intentional time set aside for student and supervisor to meet; minimum of

one hour per week on average):

___ Weekly Day ____________ From ________ To ________

___ Bi-weekly Day ____________ From ________ To ________

Location: ________________________________________________

Arranged Time Off (other than weekly day off):

______________________________________________________________________________________

______________________________________________________________________________________

Other Special Considerations:

______________________________________________________________________________________

______________________________________________________________________________________

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SECTION I

(to be completed by the intern in consultation with the supervisor)

A. Describe your long-range vocational plans.

B. What are the overall learning goals you expect to achieve as a result of this field education experience?

C. List the specific tasks assigned and ministry opportunities available which will contribute directly to the

realization of your learning goals. Tie each task to its related learning goal.

D. List other duties that will be expected of you as intern in this field setting which may not contribute

directly to your learning goals.

E. What other experiences have you had (church work, courses, readings, etc.) that will assist you in

completing these duties and learning goals?

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SECTION III

(to be completed by the Lay Training Committee chairperson or supervisor

where the LTC is not yet organized)

A. List the supporting arrangements for the intern provided by the church/institution:

Travel: ________________________________________________________________________

Meals: _________________________________________________________________________

Housing: _______________________________________________________________________

Regular time off: ________________________________________________________________

Other: _________________________________________________________________________

B. Lay Training Committee Meetings Planned (more may be scheduled if necessary or desired):

First meeting to review the Learning-Serving Covenant (2 weeks into term) on/about: _____________

Second meeting to complete the Mid-term Review (mid-term) on/about: ________________________

(for academic term placements only)

Third meeting to complete the Final Evaluation (one week before end of term) on/about: ___________

**************************************************************************************

We understand and agree to this covenant:

Intern: _________________________________________________ Date: ___________________

Supervisor: _____________________________________________ Date: ___________________

LTC Chairperson: ________________________________________ Date: __________________

SECTION IV

(to be completed by the Field Ed Office)

Date Received: ___________________ On Time ______ Late ______

Date Reviewed: ___________________ By: ________________________

Comments: ____________________________________________________________________________

______________________________________________________________________________________

Follow-Up Recommended: ________________________________________________________________

Proposed Site Visit: _____________________________________________________________________

6/5/2009