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Internship Information Form

Political Science Internship Information Form

POSC 447/448/498

When you have found an appropriate internship, please fill out the following and take to SPA 257 so it can be put into your student file.

Remember, always get permission from the Internship Director before starting an internship to make sure that you will receive credit for your internship.

Today’s Date: ______/______/_______

 

Name (last)_______________________________(first)________________________

 

Email Address: ___________________@_____________._____

 

Phone: (_____) _________-_______________

 

 

Information about the Internship:

Approximate Start Date: ____/___/ ____;

Approximate End Date: ____/___/ ____

 

Name of the Org: _____________________________________________________

 

Address: _________________________________________

City ____________________________   State ________  Zip______________ Phone _____________________________

 

Name of Internship Supervisor: _________________________________________

 

Phone Number: (_____) _________-___________________

 

Email: _________________@__________________._______

 

Brief Description of Duties and Hours/Week (Use back of sheet if necessary):