Jane Frick, Internship Coordinator
Department of English, Foreign Languages, Journalism
Social Security Number:
Local Address (include zip):
Local Telephone Number:
1. Work experience: Describe your prior work experience(s) (List places of employment, approximate dates of employment, and job duties):
If you are presently employed, list your place of employment, and briefly, describe your job duties.
Will you continue to work while completing your internship? If so, how many hours a week will you be working?
2. If you have not already registered for the semester in which you will complete your internship, list below ALL of the courses you intend to take in conjunction with your internship, along with the total number of credits (excluding the internship) in which you plan to enroll.
3. List your special training or skills (software and hardware platforms you regularly use, Web authoring languages, tutoring abilities, photography skills, etc.):
4. List your extracurricular activities (honors, awards, interests, hobbies):
5. Career objectives:
What kinds of work do you enjoy doing?
What careers or jobs are you considering?
6. Do you have additional comments which may further clarify your interests in an internship experience?
7. List agencies or organizations where you would like to do your internship.