HPA 250 Internship Form
The purpose of the HPA internship is to provide a practical learning experience in an area relevant to health policy and/or administration and/or research that complements knowledge obtained via courses in the HPA curriculum. The 3 credit internship requires 120 hours (e.g. 8 hrs per week for 15 weeks) with the schedule being mutually agreed upon by the student and sponsor.

This form should  be completed by the student in conjunction with the sponsor and will be automatically routed via email to the sponsor for approval.
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Email *
Student Last Name:
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Student First Name:
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Student Phone Number:
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Student ID Number: *
Internship Site: *
Internship Semester and Year (e.g. Spring 2024): *
Please list the student’s duties and responsibilities for the internship.
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Sponsor's Name:
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Sponsor's Phone Number:
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Sponsor's Email Address:
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STUDENTS: List Sponsor's email below; it must be accurate or the sponsor will be unable to approve your application form.
Please type your full name. This serves as your official legal signature.
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Student Date Signed:
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This form will be routed to the sponsor for approval and ultimately to Dr. Mihalko. Should you have any questions about the internship, please contact Dr. Shannon Mihalko at mihalksl@wfu.edu. If you have questions or issues with the form, please contact HPA Academic Coordinator Anna Willis at willisae@wfu.edu.
A copy of your responses will be emailed to the address you provided.
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