Application for Engage IU SOUTH BEND Interns

Fields marked with an asterisk (*) are required.

• Student Information

• Student Name *

  First Middle Last
• Student ID *
  Maximum of 10 digits allowed. Currently entered: 0 digits.
• IU Email *
• Major / minor
• Credit Hours Completed
• Cumulative GPA
• Have you received this award before? *
  Yes No
• Will this be your first internship experience? *
  Yes No
• Are you currently an undergraduate or graduate student? *
  Undergraduate Graduate

• Organization / Agency Information

• Organization / Agency Name *
• Internship Supervisor & Position Title *
• Supervisor Email *
• Supervisor Phone

  - Area Code - Prefix Line Number
• Brief Description of Organization

• Internship Description

• Start Date *

  / MM / DD YYYY
• End Date *

  / MM / DD YYYY
• Weekly Schedule *
• Internship Position Title (if applicable) * If no title enter N/A.

  If no title enter N/A.

• Duties & Responsibilities *

• Course Information

• Course Number & Name *
• Section Number *
• Number of internship hours needed to receive credit *
• Faculty Sponsor *

  First Last
• Department *
• Faculty Email *
• Faculty Phone

  - Area Code - Prefix Line Number

• Essay

• Upload an essay (up to 600 words) in which you answer the following questions:
  o What are your academic achievements in college thus far?
  o How is this internship relevant to your major/minor?
  o What new skills or experiences do you expect to obtain from this internship?
  o How will this internship help you to meet your academic and professional goals?
  o How will this internship benefit the non-profit organization? *
  Attach Files

• Consent

• I understand that: *

  The awards committee will access my transcript and contact the Internship Supervisor to verify information in this application. Failure to complete the internship will result in the termination of the award.
• I agree to: *

  Complete a survey about my internship experience at the end of the semester. Allow my photograph to be used for marketing purposes.