Application for Students

Student JTC487/687 Internship Interest Form

Student Information

Name:

Email Address (Required):

Student ID Number:

I want to enroll as an intern during:

Campus Address:

City: State: Zip:

Telephone e-mail:

My concentration is

Have you earned any JTC 487, 484, 495 or 496 credits? If so, how many?
Describe how you and what were you doing?

Qualifications

Cumulative CSU G.P.A. Expected date of graduation

List JTC courses you have completed (also list grades).

List JTC courses you are enrolled in this semester

List JTC courses you are enrolled in for the next semester

List any previous experience that relates to the work you would do in your internship.

If you plan a summer internship please provide your home or summer address below (if different from your campus address provided above).

Address

City State Zip:

Telephone Area Code and Number e-mail:

Submit this electronic form to JoAnn Cornell. Or obtain the Internship Packet by picking up a copy outside Clark C-226 (the form is in the packet). Electronic submissions are subject to review by the Internship Director.