Your name _____________________________
Year in school __________ ID __________________
Address and telephone _________________________________________________________________
Major(s) ____________________________
Minor(s) __________________________ GPA ________
Previous internship? __________ If
so, with whom? _______________________________________
List all journalism courses taken;
include grades: __________________________________________
___________________________________________________________________________________
List other courses you have taken
that will be valuable: _____________________________________
___________________________________________________________________________________
Want help in obtaining an internship?
Please tell us what kind of internship you are interested in.
___________________________________________________________________________________
___________________________________________________________________________________
If you have an internship lined
up, complete the following:
Employer's
name and address _________________________________________________________
Supervisor's name and telephone
________________________________________________________
Describe your duties __________________________________________________________________
____________________________________________________________________________________
Work Schedule _______________________________________________________________________
The
above description of duties and work schedule accurately reflect
our expectations of this intern, who will receive direct supervision
and evaluation from me.
___________________________________
(Supervisor's signature)
Approved for 3 credits __________
or 6 credits ___________
JOR 345 Instructor ___________________________
Date __________
Chair ______________________
Date __________