Internship Request Form - SU Abroad

106 Walnut PlaceSyracuse, NY 13244–2650Phone: 1 –800–235–DIPAFax: 315–443–4593Internship Request FormRÉSUMÉ GUIDELINES FOLLOWAll students requesting an internship/field placement/experience credits must complete this form (World Partner students: please see your admissionscounselor for the appropriate internship form). This information will be used to assist us in our effort to obtain and match you to a suitable placement.Internship placements are made once a student arrives at the overseas center and are subject to a successful interview with the organizationproviding placement. SU Abroad makes every effort to place students in an internship, but placements cannot be guaranteed.This form and your résumé are due MARCH 15 th for the fall semester, MARCH 1 st for the summer , and OCTOBER 15 for the spring semester.Please type or print clearlyName:Email:Program:Semester/Year/Summer:GPA:Graduation Date:Home University:Major(s):Minor(s):Please list the languages you speak and your proficiency level:Conditions: While we will make every effort to provide you with an internship/field placement/experience credits, we cannotguarantee you a placement. Placements are dependent upon the availability of suitable positions and on an interview followingyour arrival overseas. When requesting a placement, you should carefully consider the additional time that will be required(including travel) and the possibility that you may have to work on Fridays or weekends or during the semester break. Aninternship/experience credit placement is a serious commitment, which, when accepted, must be fully and responsibly fulfilled.Type or print clearly and neatly.1.Attach a typed or printed résumé. Your résumé should include (a) your name, address, and telephone number (home and school); (b)your post-secondary education (name of school, degree sought, anticipated date of graduation, major and minor subjects, cumulative andmajor grade point averages); (c) work experience (name and location of company. dates of employment, your position, description of dutiesperformed, part-time or full-time); (d) special skills (computer, statistics, etc.); (e) your hobbies/interests.2.What are your reasons for wanting an international internship?(a) What sorts of organizations would enable you to achieve the learning goals that you have? Please be specific.(b) What contributions, skills and qualities will you provide to an organization?REV 1/13

3.Outline below relevant extracurricular or voluntary activities not included in your résumé.Name and Location Type of Description of Activities Dates ofof Organization Organization (inc. leadership roles) Participation4. List courses relevant to your internship interest.Course Title5. List the titles of other courses you intend to take overseas in addition to your internship.6. Contact your school or college advisor to learn if you will be able to use internship credits toward your degree. Some schools and colleges, aswell as some departments and majors, do not allow or have specific restrictions for internship credits to count toward the degree.I authorize the release of this form and all other relevant documents in my admissions file (including academic transcripts and recommendations) toprospective placements.Student Signature:Date:REV 1/13