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:


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 9 May 2007 (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) International Internships Coordinator
International Study Programs David M. Kennedy Center for International Studies
Brigham Young University
David M. Kennedy Center Home

(1) Proposal for an Individual Internship (Form C) - Interactive
Individual Internship Proposal (doc)

(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)
International Internship Master Agreement 1 June 07 (PDF)

Deadlines: The first two forms must be completed well before your international departure:
  1 February for Fall, Spring, and Summer departures
  1 October for Winter Semester departure

Once student forms are completed students will be required to participate in a 1 credit block cultural cross training / safety and security preparation course before they depart. This course can be taken the second block any time fall or winter semester before their international field experience. Following the Kennedy Center Pre-Departure course, students will be instructed how to complete the third form when they arrive in the foreign country.

*Also note that the International Study Program will be registering the students' courses.

MPH Field Experience Forms:
(These are completed during and after your field experience, and are required appendix items for your Field Experience Report.)

Other Forms:

  • Institution Review Board Form (Form I) 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!
    IRB Application (doc)

  • Department Scheduling of Final Oral Examination (Defense)(Form J)
    *interactive* ADV Form 8c (PDF)
    Deadline: 2 weeks before project defense

  • Report of Committee Action for Final Oral Examination (Form K)
    (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 L)
    (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 M)
    *interactive* Exit Survey (Form M)
    Deadline: Varies according to graduation, before Form N

  • Department Approval of Completion of the MPH Program (Form N)
    *interactive* Departmental Approval of Completion (PDF)
    Deadline: due before clearance for graduation

Hard-copies of the forms are available in the MPH office (213 RB)