Document Name: Internship-Registration-Form.Docx Page 2 of 2
BACKGROUND CHECK CODE
Are you able to successfully pass a background check? □ Yes □ No
Do you have a valid Drivers? □ Yes □ No
Do you have reliable transportation? □ Yes □ No
CAREER INFORMATION
Have you attended the Internship Seminar? □ Yes □ No
Do you have an approved resume from Career Services? □ Yes □ No
What field or type of experience are you interested in for the internship experience?
HOW MANY HOURS PER WEEK ARE YOU AVAILABLE TO COMMIT TO THE INTERNSHIP? _________________________________________________
D
ATE AVAILABLE: ____________________________________________ ___________________________________________________
S
TART DATE END DATE
REFERENCES
List two references from the campus. References can be either academic or administration
REFERENCE ONE NAME: _______________________________________ ___________________________________________________
L
AST FIRST
R
EFERENCE TWO NAME: _______________________________________ ___________________________________________________
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AST FIRST
AUTHORIZATION
I attest the information provided is true and accurate. If changes occur, I will follow-up with the Office
of Career Services to update my information. (Type in your RAM ID/Last, First Name)
NAME: _____________________________________ __________________________________ RAM ID: _______________________
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AST FIRST
