Public School Placement Form - Approved Public School Districts
This form should be used to process CSUF practicum or internship experiences at a school that is a member of one of the Approved School Districts viewable through the link below. A Public School Placement Form must be submitted for every semester and public school at which you plan on receiving course credit. Prior to completing this form, please make sure you meet the following criteria:

• You are enrolled in one of the following courses: PSYC 495, CAS 394, CAS 454, CAS 464, CAS 474, CAS 494, or COMD 495
• You have secured a position with a school within an Approved School District*
• You have received instructions from your school regarding the process for obtaining background checks and/or a TB test
To view a list of approved school districts, visit If your district is not located on this list, please contact CICE at 657-278-3746 for immediate assistance and instructions.
Please use the following section to share a few details about you and your planned internship/practicum course.
First Name *
Your answer
Last Name *
Your answer
Preferred Email Address *
Your answer
Preferred Phone Number *
Your answer
Campus-wide ID
Your answer
Course Information *
Course Instructor *
Your answer
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