Internship Confirmation Form

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Once you have confirmed your internship, you need to complete this form entirely and submit it as soon as possible, but no later that the first day of the session for which you are seeking credit. Before submitting this form please make sure that you have no holds on your bursar account. Your internship should entail a temporary position in risk management or insurance paying at least $8.00 per hour. You must work 150 hours to receive 3 credit hours and 300 hours to receive 6 credit hours. Please check your bursar’s account to make sure that you are registered for (and are paying for) the correct number of hours. Three hours of internship credit costs the same as a regular 3-hour summer session class. Six hours of internship credit costs the same as two regular 3-hour summer session classes. So while you are earning money during the internship you will need to pay for the credit as you would any other class. Your internship supervisor will be contacted for feedback regarding your performance on the job.

Email *

Your Last Name *

Your First name *

Your Student ID Number *

Internship Employer Name (e.g. Rebel Insurance Company) *

Employer City *

Employer State *

Employer Website *

Supervisor First Name *

Supervisor Last Name *

Supervisor Phone Number *

Supervisor Email Address *

Hourly Compensation *

Hours Per Week to Work *

Starting Date *

YYYY

Ending Date *

YYYY

Number of Credit Hours Requested *

3 Hours

6 Hours

Required

Briefly Describe your Duties in this Internship *

Date on which you confirmed that you have no holds on your bursar account *

YYYY

Semester, and year, that you passed (or expect to pass) FIN 341 *

A copy of your responses will be emailed to the address you provided.

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