Forms and Deadlines
“Great things are not done by impulse,
but by a series of small things brought together.”
— Van Gogh
BYU requires a series of procedures that help students obtain appropriate clearance to progress in the MPH program. These procedures are met through approval granted by your MPH committee or BYU administrators given the following forms. Students hold primary responsibility and committees hold secondary accountability to assure that appropriate department and university forms are complete. Thus, it is recommended that each student and her/his academic advisor regularly review upcoming forms and requirements. They are listed in the general order most students may need them:
General Forms
Program of Study for Graduate Students (coursework & committee approval)
*interactive* ADV Form 3 (PDF)
Deadline: 3rd Week of Winter Semester
Request for Program of Study Change (approval to change coursework)
*interactive* ADV Form 3b (PDF)
Deadline: No specific deadline
MPH Graduate Practicum Proposal Meeting Scheduling Form
*interactive* Practicum Proposal Scheduling 2 (PDF)
Deadline: 1 week before practicum proposal(s) (See Sandy Alger, 214 RB)
MPH Practicum Approval Form
*interactive* MPH PRACTICUM APPROVAL FORM (PDF)
Deadline: 2 weeks before scheduled defense meeting(s)
University Field Experience Forms
*you will complete either the domestic or international field experience forms*
Domestic field experience forms:
(Submitted through Joleen Rowan (221 RB) for signatures then delivered to Academic Internship Office (422-3337))
(1) Master Internship Agreement (Form A) and Student Agreement Form
(Exhibit A) Master Internship Agreement 28 Jan 2008 (PDF)
(2) Experience Provider Information Sheet (Form B)
Experience Information Sheet (PDF)
Deadline: must be complete before you begin field experience with your agency.
International field experience forms:
(Submitted to Aaron Rose (204 HRCB) at the Kennedy Center (422-8241))
(1) Proposal for an Individual Internship (Form C) - Interactive
Individual Internship Information
(2) ISP Application - Interactive
ISP Application Home
(3) International Internship Master Agreement, International Internship Student Agreement, AND Assumption of Risk, Release of Claims, and Indemnity (Form D)
(This form is submitted through Joleen Rowan (221 RB) to the Internship Office)
International Internship Affiliation 28 Jan 08 (PDF)
Deadlines: The first two forms must be completed well before your international departure and are submitted to Aaron Rose (204 HRCB)
1 February for Spring Term, Summer Term and Fall Semester departure; and
1 October for Winter Semester departure
Once student forms are completed, you will be able to participate in the required Pre-Departure Seminars conducted at the Kennedy Center. Following Kennedy Center Pre-Departure Seminars, students will be instructed how to complete the third form when they arrive in the foreign country.
MPH Field Experience Forms:
(These are completed during and after your field experience, and are required appendix items for your Field Experience Report.)
Field Experience Log (Form E)
*interactive* Department Form E (PDF)
Learning Outcomes for Fieldwork - Mid-way Assessment (Form F)
Department Form F (Word .doc)
Learning Outcomes for Fieldwork - Post Assessment (Form G)
Department Form G (Word .doc)
Fieldwork Assessment of BYU Student Intern (Form H)
Department Form H (Word .doc)
Agency Recommendation Report (Form I)
Department Form I (Word .doc)
Grading for Field Experience (Form J)
Advisor completes this form
Human Subjects (IRB) Form:
Institution Review Board Form (Form K)
This form, also known as human subjects’ approval, must be completed for most circumstances given the three graduate project options available in the MPH. The IRB must be completed and approved before your graduate project begins.
Other Important Forms:
Department Scheduling of Final Oral Examination (Defense)(Form L)
*interactive* ADV Form 8c (PDF)
Deadline: 2 weeks before project defense
Report of Committee Action for Final Oral Examination (Form M)
(Does not require student involvement - This form is given to the committee chair in a packet, through Sandy Alger (214 RB))
Application for Graduation (Form N)
(see Office of Graduate Studies or Sandy Alger in RB 214 for specific deadlines)
ADV Form 8a (PDF)
Deadline: Varies according to graduation
Exit Survey (Form O)
*interactive* Exit Survey
Deadline: Varies according to graduation, before Form P
Department Approval of Completion of the MPH Program (Form P)
*interactive*
Departmental Approval of Completion (PDF)
Deadline: due before clearance for graduation
MPH Learning Outcome Assessment: Final Self-Assessment (Form Q)
Department Form Q (Word .doc)
Deadline: due before clearance for graduation
Hard-copies of the forms are available in the MPH office (213 RB)