Internship Proposal INTAKE Form

Who should fill this INTAKE form out and why?

In order for a student to propose/apply for an Internship, they must first fill out this "Internship Proposal INTAKE form."

NOTE: Although someone appropriately postitioned to fill out this form on behalf of the student may do so, the student who wants to propose an Internship for themselves is the intended/preferred filler.

***If you fill out this "Internship Proposal INTAKE Form," please make sure you do so AT LEAST 5 weeks prior to start date of your proposed Internship because the SUBMISSION DEADLINE for the COMPLETED (filled and signed by all affected parties) "Internship Proposal Form" itself is 4 weeks prior to the start date of your proposed Internship. In other words, giving AT LEAST A FULL WEEK (although as much time as possible is recommended) for all fillers/signers to complete their roles on your Internship Proposal Form gives you a reasonable chance of getting it completed by the submission deadline 4 weeks prior to the proposed start date).

After submission of this "Internship Proposal INTAKE form," all affected parties will be emailed the official "Internship Propoal Form" by the Registrar's office. Each party will be asked to fill in certain form fields and/or submit their e-signatures. When all form information and e-signatures have been collected, each party will be emailed a fully signed and completed copy of the "Internship Proposal Form" for their information and records.

Finally, the Registrar's office will notify (email) all affected parties as to whether the Internship Proposal has been APPROVED, APPROVED WITH CONDITIONS/MODIFICATIONS, or DENIED.

Any questions or concerns? Email registrar@miu.edu

"*" indicates required fields

Student Name*

First Last

Student ID*

should begin with 6, 9, or 1

Student (Preferred) Email*

Proposed Start Date*

Proposed End Date*

Student Level*

Undergraduate

Graduate

Department Chair Name*

First Last

Department Chair Email*

work email only

Name of Student's Degree Program*

Faculty Supervisor Name*

First Last

Faculty Supervisor Email*

work email only

Academic Advisor Name*

First Last

Academic Advisor Email*

work email only

(OPTIONAL) If there is a person(s) (not already listed on this form--including yourself) for whom you believe a completed copy of the "Internship Proposal Form" should be sent after all parties have filled and signed it, please list the following info about them below: 1) NAME (FIRST LAST) 2) EMAIL 3) PHONE 4) ACADEMIC RELATIONSHIP TO THE STUDENT/JUSTIFICATION FOR RECEIVING THIS COMPLETED FORM. If the Registrar deems it academically necessary and in accordance with FERPA regulations for this person(s) to receive a completed copy, it will be done.

Current Students

Current Students

Current Students

Internship Proposal INTAKE Form