Interns in Industry Student Application

Name:
Phone:
Address:
E-mail:
Are you legally eligible for employment in the U.S.?	Yes No
Permanent Address:
School Name:
Dates Attended
School Address:
Campus Location:	City State
Expected date of graduation:
Major/Minor(s)
Faculty/Advisor	Name Title
E-mail:
Phone:
Internship Position(s) & Announcement #(s)
Is an internship required in your major/program?	Yes No
If yes, describe requirements:
If no, are you applying for credit for the internship?	Yes No #Cr. Hrs.
Dates you are available to complete the internship:
Other comments that may assist us in selecting you as an intern?
Please upload your resume here:
Please upload your Cover Letter here: