Brokers Internships

INTERNSHIP

Registration Form

Deadline: by the last date for withdrawl
from classes with a "W" Grade

Important: Internships are defined as activities that predominantly involve job or job-related experience. They may take place off campus, at individual places of employment; or campus, in a particular office or department; or as classroom internships on campus, within a specific academic department.

(In contrast, Independent Special Studies are defined as activities in which a student engages in a project outside of regularly scheduled classes that consists of a predominantly academic component.)
  1. Make sure you have the correct form for your activity.
  2. Read the regulations on the Internship Info page.
  3. All sections of the form must be completed.
  4. Submit to Registrar's Office for registration, in addition to whatever form(s) or conditions expected by the sponsoring department.
NAME:
Last _________________________________________________________
First_________________________________________________________
MI____________________________________________________________
Year of Graduation____________________________________________
TITLE of INTERNSHIP:
______________________________________________________________
Sem/YR to be conducted________________________________________
Department____________________________________________________
Course No.____________________________________________________
Credits (up to 4)_____________________________________________
DESCRIPTION OF INTERNSHIP:
______________________________________________________________
______________________________________________________________
______________________________________________________________
(Note: Student must submit a complete written proposal to the faculty sponsor, including a detailed description of the internship, with the academic dimensions, required activities, ovjectives, and methods of evaluation.)
FINAL PROJECTS TO BE EVALUATED:
______________________________________________________________
______________________________________________________________
(e.g. time log, journal, detailed account of performance, etc.)
Place of Internship_______________________________________________
Address_______________________________________________________
Off-Campus Supervisor___________________________________________
Phone_________________________________________________________
Role of off-campus supervisor in final evaluation and supervision:
______________________________________________________________
Role of faculty supervisor in supervision:
______________________________________________________________
Number of Weeks devoted to project:
______________________________________________________________
Number of hours per week devoted to project:
______________________________________________________________
Total number of hours devoted to project:
______________________________________________________________
GRADING: Credit/Fail ONLY
Faculty Sponser:
______________________________________________________________
Internship Sponser:
______________________________________________________________
Student:
______________________________________________________________
(Print out form and turn into Joe Carter x2459, Winslow 116)