COMM 4670 PRELIMINARY INTERNSHIP APPLICATION

Complete both sides and submit to Dr. Patterson. Must do * items.

*Name: _________________________________ *Senior:   Yes      No
               (print legibly)

*Number of internship credit hours planned:   3    6    9

*Communication Emphasis:   SPC    PR    ORG

*Term of Internship:   Fall    Spring Summer    Yr: _____

*Total Credit Hours Earned (min 90):  In Major  _______   *  In Specialty: _______

*Overall GPA  (2.5 min)  ________ *Specialty GPA ________

*Your Advisor: ____________________________________

* Your Local Address: ________________________   City ____________   State/Zip ________

*Permanent Address: ________________________    City____________   State/Zip ________

*Local Phone: ____________________   Permanent Phone: ____________________

*e-mail _______________________

*Have you selected an internship organization?               Yes    No

     If yes, have you made contact with the company?     Yes    No

     …do you have a preliminary agreement?                     Yes    No

Name of Organization: _______________________________________________

Address: __________________________________________________________

City: ___________________________   State/Zip: __________________________

Name of Contact Person/Supervisor: ____________________________________

Department within Organization: _______________________________________

Function of Department: ______________________________________________

OVER

Preliminary Internship Form p.2 Must do all items on this page.

What is your reason for/or objective in interning?

What experiences have you already had in your communication specialty?

What five communication specialty courses have you already had?

Which ones do you not have?

What special skills do you have? (e.g., write or speak well, computer literate, photography, television or radio qualified, math, foreign language etc.)