Fillable Professional!Internship!Program! Student!Application!and!Advisor!Approval!Form! (Nazareth College)

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Professional!Internship!Program! Student!Application!and!Advisor!Approval!Form! (Nazareth College)

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The Professional!Internship!Program! Student!Application!and!Advisor!Approval!Form! (Nazareth College) form is 1 page long and contains:

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  • 11 check-boxes
  • 29 other fields

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File type: PDF

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!
Professional!Internship!Program!
Student!Application!and!Advisor!Approval!Form!
!
Instructions
Please complete this form (you may do so electronically). You must secure your Faculty
Advisor’s approval as indicated by his or her signature. Your signature is required as well.
You should make copies of this completed form for your Faculty Advisor and the instructor
of your Internship Seminar. It is your responsibility to make certain that all concerned parties
have a copy of this document.
Student
Information
First Name:
Last Name:
Campus/Local Street Address:
State:
Zip:
Main Phone Number:
Permanent/Home Street Address:
State:
Zip:
Permanent/Home Phone Number (with area code):
Campus
E-mail:
Personal E-mail (if
preferred):
Internship
Information
Type of Internship Sought (HR/finance/CYD, etc.):
Course Number and Title:
Is this your 1
st
Naz internship?
Year:
Semester:
Fall
Spring
Summer
Academic
Information
Major:
Second
Major/Concentration:
Academic Standing:
Junior
Senior
Other
Nazareth GPA:
Number of Semesters at Nazareth:
If transfer, provide the name of the previous institution:
Do you want this experience to fulfill your Experiential Learning
(EL) requirement (new/2013 Core Curriculum students)?
Yes No
Approval for
Student to
Complete
an
Internship
Advisor’s Comments:
Approved
Conditionally Approved
Not Approved
Advisor’s Name:
Advisor’s Signature:
Student’s Signature:
Nazareth
Contact
Information
Questions, concerns, or issues should be directed to:
Internship Program
Center for Life’s Work
Nazareth College of Rochester
4245 East Avenue
Rochester, New York 14618-3790
Office: GAC-111
Phone: 585-389-2878
E-mail: internships@naz.edu
Web Sites: www.naz.edu
You may also direct inquiries to your specific Department Internship Coordinator.
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ProfessionalInternshipProgram StudentApplicationandAdvisorApprovalForm (Nazareth College)

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Completed 24 August 2020

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