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Teacher Education

Internship Application

Prospective Teachers

Internship assignments are made cooperatively by Lewis & Clark and school district personnel. The information you provide here will assist teacher education faculty in matching you with specific mentors in K-12 schools. We attempt to honor student preferences, but school district needs and availability of mentors take priority. Information off this form, along with your resume, will be shared with school districts for placement purposes.

This form is a fillable PDF form. You should be able to fill it out on your computer and submit it as an email attachment.  If you cannot fill out the attachment on your computer, or if the “Submit”, “Save” and “Print” buttons do not work, please check and be sure that you have opened the attachment in Adobe Reader (see link below). Other PDF reader programs will not allow you to print, save, or submit.

 Early Childhood/Elementary Intern Placement Application

Middle Level/High School Internship Application

You can also print your completed form, and submit it by fax or mail to:

Teacher Education Office
Graduate School of Education and Counseling
Lewis & Clark
0615 SW Palatine Hill Road
Portland, OR 972019
503 768-6100
503 768-6115 (fax)


If you have problems or questions about the form, please contact the Teacher Education Office at: 503-768-6100.