This form must be completed and submitted to the department internship coordinator at least one week prior to the start of classes in the term for which internship credit is sought. You will be notified regarding approval of the internship for credit prior to the beginning of classes.
NAME _______________________________________
Date _______________________________________
Major ______________________________________
Classification (Fr., Soph., Jr., Sr.)_______
Internship term (Fall/Spring) ____________________ Year _____________
How many hours credit are you seeking? ___________
Have you taken other internships for credit (Y or N)? ________ if so, course # _________
Are you accepted for an internship (Y or N)? ____ if so, is it approved by Career Services?_____
Are you in the process of applying for internship(s) (Y or N) _____
List the the internship(s) applied for. Is each approved by Career Services?
When will you know if you have been accepted?
Do you have a specific type of internship in mind (Y or N) _____
What steps have you taken to find an internship?
Attach your responses to the following. Responses must be typed.
1. Describe the internship you have set up/applied for/are interested in.
2. How does your course work relate to this internship?
3. How does this internship relate to your course work?
4. How does this internship relate to your career goals/personal or academic development?
5. Do you have a preference for internship supervisor?

