Muskingum College

Internship Interest Form

Your answers to the following questions will guide the internship director in assisting you with your internship search. Please answer as completely as possible.

1. Name _________________________________ Date: ___________________________

2. Campus Address ________________________ 3. Phone: _______________________

4. Major: ________________________________ 5. Minor: _________________________

6. Year in college: ________________________ 7. Grade point average: _____________

8. Semester/Summer for which internship is desired: _____________________________

9. Internship for credit/non-credit: _____________________________________________

10. Type of internship position desired and/or description of skills which you want to develop and apply during this internship:_________________________________________________________________

__________________________________________________________________________

11. Specific courses you have taken related to this area: ___________________________

__________________________________________________________________________

12. Related work/personal experience: _________________________________________

__________________________________________________________________________

13. Reasons for applying for this internship: _____________________________________

__________________________________________________________________________

14. Agencies/organizations to which you are thinking of applying: ____________________

__________________________________________________________________________

15. Concerns/limitations you foresee (e.g. need for a paying internship, specific geographic location, site requirements, accommodations): ______________________________________________

__________________________________________________________________________

16. List professor(s) most familiar with your performance: __________________________

__________________________________________________________________________

Adapted from: St. Cloud State University, Department of Speech Communications, 720 Fourth Avenue South, St. Cloud, MN 56301-4498



		Internship Interest Form Your answers to the following questions will guide the internship director in assisting you with your internship search. Please answer as completely as possible. 1. Name _________________________________ Date: ___________________________ 2. Campus Address ________________________ 3. Phone: _______________________ 4. Major: ________________________________ 5. Minor: _________________________ 6. Year in college: ________________________ 7. Grade point average: _____________ 8. Semester/Summer for which internship is desired: _____________________________ 9. Internship for credit/non-credit: _____________________________________________ 10. Type of internship position desired and/or description of skills which you want to develop and apply during this internship:_________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 11. Specific courses you have taken related to this area: ___________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 12. Related work/personal experience: _________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 13. Reasons for applying for this internship: _____________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 14. Agencies/organizations to which you are thinking of applying: ____________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 15. Concerns/limitations you foresee (e.g. need for a paying internship, specific geographic location, site requirements, accommodations): ______________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 16. List professor(s) most familiar with your performance: __________________________ __________________________________________________________________________ __________________________________________________________________________ Adapted from: St. Cloud State University, Department of Speech Communications, 720 Fourth Avenue South, St. Cloud, MN 56301-4498