History Internship Checklist
Before getting clearance to enroll in the History internship course, please complete and
submit the following documents to the Internship Coordinator:
1. Internship Application
2. Memorandum of Understanding
Upon completion of your internship, the following documents need to be gathered and
emailed to the Internship Coordinator, Dr. Isadora Helfgott, at ihelfgot@uwyo.edu.
Materials are all due one week before the end of the semester.
1. Internship Hours log
2. Minimum 15 page paper detailing the tasks undertaken and accomplished, a
summary of your experiences, description of how what you did fits in with
the mission of the larger institution.
3. 5-8 page paper evaluating your experience: Were you prepared? Were goals
met? Did your history courses prepare you for this experience? What did you
learn? Evaluation the internship.
4. Copies of any written documentation produced by the students.
5. Photo of you doing internship work
If you would prefer to submit hard copies of your materials, you can send it to:
Internship Coordinator
History Program
Dept. 3198
1000 E. University Ave
Laramie, WY 82071
To receive a final grade for internship credit, all the above materials must be submitted in
a timely manner. Mid-term and Final Assessments from internship supervisors are also
required for full credit. It is your responsibility to remind your supervisor to email or
mail their evaluations at the appropriate times of the semester.
Internship Application
Semester:_________
Name:_____________________________________________________________________
First
Initial Last
Local Address:
_______________________________
_______________________________
Local Phone: ____________________
Permanent Address:
______________________________
______________________________
e-mail: ________________________
Total Earned Hours: _______ History GPA:_______ Overall GPA: _______
Internship Prerequisites
-12 hours of history; completion of HIST 1210/1211 and 1220/1221, 1250/1251 and 4050, or
advanced standing as a history major; or consent of instructor, or graduate standing.
(underline which prerequisite)
-Minimum 3.0 History GPA.
List history prerequisite courses:
Course Number
Credit Hours
Semester Taken
Grade Earned
HIST
HIST
HIST
HIST
Student (Intern) Objectives
Briefly, discuss your academic goals/objectives of this internship.
Note: Full credit in the course is contingent upon successful completion of the internship
practicum as outlined in this application and memorandum of understanding.
Signatures
Student: _________________________________________________________
Date
Faculty Advisor/Sponsor: ____________________________________________
Date
University of Wyoming
History Program
Dept. 3198
1000 E. University Ave
Laramie, WY 82071
___________________
ihelfgot@uwyo.edu
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Memorandum of Understanding
University of Wyoming
History Program
Dept. 3198
1000 E. University Ave
Laramie, WY 82071
___________________
ihelfgot@uwyo.edu
________________________________ has agreed to work as an intern with
(Name of Student)
______________________________________, and will be engaged in the following
(Name of Organization)
general assignments:
The period of the internship is from ________________ to _____________________.
(Beginn
ing date)
(Ending Date)
The intern will be on-the-job _______ hours per week.
The work site address is:
________________________________________
_________________________________________
Phone number: _( ) ________________Fax : _( ) ________________
e-mail: ______________________________________
Conditions of Internship
The intern supervisor will either email or mail midterm and final assessments to the Internship
Coordinator.
Agency/Organization Requirements
Agency/organization will provide adequate supervision of intern. Minimum hours per week and
term of internship will be as indicated above. The intern will comply with organization’s polices
and procedures. The intern will fulfill the following specific conditions/responsibilities/tasks
identified by the agency/organization:
Minimum hours per week and term of internship as indicated above.
Signatures
Student: _____________________________________________________________
Date
Faculty Advisor/Sponsor: ________________________________________________
Date
Department Head: _____________________________________________________
Date
Intern Supervisor: _____________________________________________________
Date
Intern Supervisor email:___________________________Phone:________________
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INTERNSHIP HOURS LOG
University of Wyoming
Department of History and American Studies
History Program
HIST 4400: Internship
Agency/Organization________________________________________________________
Intern______________________________________ Semester: _____________________
Note your hours on this log with date and time (example 01/28/13 04/30/13)
Date Hours Worked
Week 1 ____________________ ____________
Week 2 ____________________ ____________
Week 3 ____________________ ____________
Week 4 ____________________ ____________
Week 5 ____________________ ____________
Week 6 ____________________ ____________
Week 7 ____________________ ____________
Week 8 ____________________ ____________
Week 9 ____________________ ____________
Week 10 ____________________ ____________
Week 11 ____________________ ____________
Week 12 ____________________ ____________
Week 13 ____________________ ____________
Week 14 ____________________ ____________
TOTAL HOURS _________
A minimum of 100 hours must be completed in order to get credit for HIST 4400.
Intern signature _________________________________ Date:_______________
Supervisor signature:_____________________________ Date:_______________
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Return to:
Midterm Assessment
Site Supervisor’s Report
Internship Coordinator
ihelfgot@uwyo.edu
Internship Coordinator
History Program
Dept. 3198
1000 E. University Ave
Laramie, WY 82071
Instructions
INTERN SUPERVISOR: Please complete this sheet, then email or mail to the above address.
Due Date: _______________________
Intern’s Name:_________________________________________
Intern Supervisor: ______________________________________
Name and Address of Agency/Organization: ______________________________________
_________________________________________________________________________
Please assess intern’s performance and progress at this point with special reference to their
contribution to your organization’s purposes and programs. Please also make any additional
comments, which you think would be helpful to the intern and the Department of History.
Please give your assessment of the intern regarding:
Excellent
Satisfactory
Unsatisfactory
Attendance & Punctuality
Reliability
Cooperation with co-workers
Follows instructions of supervisor
Understand of agency’s/organization’s goals
Overall competence
Supervisor Signature: _________________________________________________________
Date
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Return to:
Final Assessment
Site Supervisor’s Report
Internship Coordinator
ihelfgot@uwyo.edu
Internship Coordinator
History Program
Dept. 3198
1000 E. University Ave
Laramie, WY 82071
Instructions
INTERN SUPERVISOR: Please complete this sheet, then email or mail to the above address.
Due Date: _______________________
Intern’s Name:_________________________________________
Intern Supervisor: ______________________________________
Name and Address of Agency/Organization: ______________________________________
_________________________________________________________________________
Please assess intern’s performance and progress at this point with special reference to their
contribution to your organization’s purposes and programs. Please also make any additional
comments, which you think would be helpful to the intern and the Department of History.
Please give your assessment of the intern regarding:
Excellent
Satisfactory
Unsatisfactory
Attendance & Punctuality
Reliability
Cooperation with co-workers
Follows instructions of supervisor
Understand of agency’s/organization’s goals
Overall competence
Supervisor Signature: _________________________________________________________
Date
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signature
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