INTERNSHIP PROPOSAL

Submit this completedform to Steve Pugmire -

Student Information:

Name: Click here to enter text.

UVID: Click here to enter text.

PhoneNumber: Click here to enter text.

Email: Click here to enter text.

Major: Click here to enter text.

DateofApplication: Click here to enter text.

Semester: Click here to enter text.Year: Click here to enter text.

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Internship Description:

  1. PositionTitle and Company: Click here to enter text.

Startdate: Click here to enter text.

Enddate: Click here to enter text.

Hoursofworkperweek: Click here to enter text.

How many hours will it take you to complete your internship objectives/proposed project? Click here to enter text.(Note: “All semester”is not a sufficient/appropriate answer. Instead, how many hours?)

Desired Credits? Click here to enter text.(For every 60 hours worked you will receive 1 credit hour — Note: UVU allows a maximum of 9 internship credits earned. However, the maximum allowed credits hours applied toward a student’s major is dependent on each department and their academic requirements)

Desired Course (i.e., [course initials] 281R/481R)? Click here to enter text.

Rateofpay: Click here to enter text.Nonpaid: ☐Click here to enter text.

  1. Internship Description (Not just your job title, but what are your duties and responsibilities at your workplace. You may attach a copy of your HR description or the job announcement to satisfy this section):
  1. Job vs. Internship: What will you learn that you do not already know?
  1. Description of your Personal and Educational Goals (How will this internship expand your knowledge and help you in meeting the goals you have for your education?):
  1. Outcomes from Internship: What outcomes do you expect from your internship that will enable you to measure if the opportunity is successful?

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Internship Site Supervisor Information:

  1. SiteSupervisorName: Click here to enter text.

Title: Click here to enter text.

Company/Organization:Click here to enter text.

OfficePhoneNumber: Click here to enter text.Ext: Click here to enter text.

Email: Click here to enter text.Fax: Click here to enter text.

Address: Click here to enter text.

  1. Company Description (Provide a brief description of what it is that your company does. If you have a link to the company web page, or a brochure, please attach as well):

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-For Office Use Only-

Faculty Supervisor & Course Information:

FacultySupervisorName: Click here to enter text.

Email: Click here to enter text.

InternshipCourseNumber: Click here to enter text.

NumberofCredits: Click here to enter text.