* Email document to Gayla Schock, a minimum of 30 days prior to the begin date of placement at gayla.schock@bia.gov. If there are
any changes to the begin and end dates, resubmit the form.
BIA - OFFICE OF TRUST SERVICES
PATHWAYS INTERNSHIP PROGRAM
Host Office Intern Request
PURPOSE: To initiate a request for one or more interns. Requestors that volunteer to host an intern should accurately describe the
work tasks and training assignments for the intern(s) to improve recruiting and skill matching for the host unit. In all cases, it should be
noted that the student intern’s work schedule should be designed and monitored to ensure it supports the student’s ability to complete
their required academic work. Interns must be hosted by the BIA but may be placed with tribe or tribal organization. Administrative
requirements are retained by the BIA. Procedural questions on completing this request or on other aspects relating to the Pathways
program should be addressed to: gayla.schock@bia.gov.
Number of Interns requested:
Start on __________________ End on__________________ Hours Per Week__________________
One year, Not-to-Exceed 2 years On-going (job shadowing, exposure to a career)
Summer and during breaks Part-time and year round
forestry natural resource management agriculture / rangeland soil conservation / science
other (describe): ___________________________________________________________________
Type of Assignment (check all that apply): On detail to BIA office assigned to tribe, tribal organization.
Hosting Unit Information and Intern Work Site Location
FEDERAL AGENCY
(Required)
TRIBE, TRIBAL ORGANIZATION
(If applicable)
Are lodging accommodations available? NO YES If YES, provide description:
Are there any other in-kind contributions / cost sharing / leverage opportunities provided (travel expenses, local, tribal or formal
training opportunities, tuition assistance, other)? NO YES If YES, provide description:
Provide brief summary description of the work and training for intern(s), indicate primary focus (attach page with details):
Name and Title:_______________________________________________________________________________________
Signature:_________________________________________________ Date:_____________________________
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