On behalf of ________________________________________________________, we agree that
                                       (Church or Institution)

_____________________________________________________________________ 
                                                 (Student)

will be undertaking his/her field education experience in our setting. We further agree that we will participate in the aforementioned training and will be faithful in the observance of dates for submission of a Learning Agreement, a mid-year evaluation, and a final evaluation.
 

___________________________________________    _______________________________ 
(Supervisor)                                                              (Date)

I have been qualified as a Supervisor at ____________________________ Seminary in the year _________________

I will be taking Supervisor’s training at BUSTH______________ , at __________________________________

________________________________________________           _______________________________ 
(Internship Committee Chairperson’s signature)                                      (Date)
 

________________________________________________            _______________________________
(Task Supervisor’s signature, if different from field supervisor)                (Date)
 

________________________________________________             _______________________________ 
(Director or Assistant Director of Profesional Education’s signature)         (Date)
 

If your setting is affiliated with other another seminary, which is it? ________________________________

(Part of the agreement among BTI seminaries is that churches or agencies are listed as a setting for one school only. While a setting can have students from any seminary, each setting must maintain one primary school affiliation. If you are not sure to which school your setting belongs, please call the Office of Professional Education at 617-353-3037.)