Print Email Share Tweet Student’s Name: SE ID (S0#######): Major: Total Hours Completed Total Hours Completed in SC Courses Campus Address Campus Phone Cooperating Agency Information Company Name Company Address Supervisor Title Phone Number Internship Title for Permanent Records Starting Date of Internship Closing Date of Internship Number of Weeks of Internship List of Internship Work Tasks: Additional Requirements to be fulfilled before credit is granted for internship/practicum: Weekly Time Log to be submitted via email at the end of each weekly period for the total of 150 hours worth of work. Two on-job work samples representing the internship (can be in draft form). Supervisor’s Internship Performance Review Form. Self & Program Evaluation Form. All materials and information submitted for your Internship/Practicum become property of the Department of Communication Studies to be maintained in the main department office. These items cannot be returned. Student’s Signature ____________________________________________ Date _________________________ Company Representative’s Signature ____________________________________________ Date _________________________ Internship/Practicum Coordinator's Signature ____________________________________________ Date _________________________ Department Chair’s Signature ____________________________________________ Date _________________________ News Calendar Current TodayPlease Enable JavaScript.
