Course Reg
istration Approval Form
Internship/Cooperative Education
Course Registration Approval Form
Student Information
Student Name: Student ID:
Email Address: Phone Number:
Major: Minor: Overall GPA:
FR SO JR SR Master's
Expected Graduation Date:
How did you find your Internship / Co-op position?
Internship Information
Company/Agency:
Address:
City/State/Zip Code:
Supervisor: Phone:
Email:
Description of Job Responsibilities:
Faculty Approval
I recommend ___________________________ to participate in the Internship/Cooperative
Education program for ______ hours in the Fall Spring Summer semester of 20___.
_______________________________ __________________
Faculty Signature Date
I have received the syllabus for the internship and understand the requirements for the course.
_______________________________ __________________
Student Signature Date
For Departmental Use Only
Assigned Course Number: ________________________ Course Code: __________________
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