Before beginning any internship for which you wish to receive academic credit, you must:
Complete this application and submit it to the faculty internship coordinator.
Obtain an override from faculty coordinator in order to register for appropriate internship course.
Register and pay for internship credit
Please complete the following information:
Name
ID
Address
Local Phone
City, State, Zip
Email
Permanent Address
Permanent Phone
City, State, Zip
Address during Internship if Different
Courses Completed as Prerequisites for Internship:
Other Courses or Experiences which may qualify you for a placement:
Placement Preferences: (Type of Agency and Location):
If placement has already been arranged please provide following information:
Supervisor Name
Title
Organization/Agency
Address
Phone
City, State, Zip
Email
REMEMBER:
Turn in this form to a faculty internship coordinator.
Obtain an override in order to register.
Register and pay for the internship credit.
With your internship supervisor, complete the training agreement and return to the faculty internship coordinator no later than the first week of the internship.
During the internship keep in contact with your faculty internship coordinator.
Keep an internship log and write internship papers.
Complete Student Evaluation of Internship form and have internship supervisor complete Evaluation of Intern form.
Turn in all work and forms to the faculty internship coordinator by the deadline.
I understand the requirements of the internship and will comply with all requirements.