Kent State University

AD Internship Application

How to Apply
After you've determined if you have fulfilled the internship requirements and met with the Internship Coordinator, complete an application form. You will be registered for your internship only after it is approved and the application form is completed.

Provide previously unknown details as soon as possible after the internship begins. We need to know your starting and ending dates, hours, and duties. The School will write to your internship supervisor confirming this information.


Register # Hrs

Your Catalog Year
Last Name
 
First Name
Middle Initial
Banner ID#
(ex: 810XXXXXX)
 
Major
 Current GPA
Total hrs. at end of semester

Current Internship Info
Is this a paid internship?
Company Name
Semester requesting internship registration
Internship Business Address (Street)
City
State
Zip
Phone
Fax
Supervisor
Last Name First Name
Supervisor Title/Job Description
 
Supervisor
e-mail
Internship Starting/Ending dates
Hours to be worked per week
 
Describe major duties

Student information
Home Address (During Internship)
  
City
State
Zip
Home Phone# (During Internship)
Office Phone# (During Internship)
Email Address
 
Permanent Home Address
City
State
Zip

JMC Courses Completed
(note with * current semester’s courses)
Course Name
Course Number

Student acknowledges report requirements

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