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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):