Practical Experience Approval Form
Prior to submitting this form, please discuss this practical experience with your Concentration Advisor
Choose the name of your concentration
*
Please Select
Archives
Book Studies
Collaborative Innovation
Community Engagement & Social Change
Environmental
Global Finance
Interdisciplinary Making
Journalism
Museums
Poetry
Translation Studies
Student Name
*
First Name
Last Name
Student Email Address
*
example@smith.edu
Planned Graduation Year
*
Form Submission Date
*
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Month
-
Day
Year
Date is auto-filled
Concentration Advisor Name
*
First Name
Last Name
Concentration Advisor Email
*
Form will be sent to your adviser for approval, please ensure correct spelling
Details of the internship, volunteer, or work experience
Name of Organization
*
Type in the name of the organization or business where you will complete your practical experience
Organization Website
Location
Type in the city and state (or country); please specify if remote
Internship Supervisor Name
First Name
Last Name
Supervisor Phone Number
Format: (000) 000-0000.
Supervisor Email
Describe the proposed internship, volunteer, or work experience, including the type of work you will do and the kind of supervision you will receive.
*
How will this practical experience support your work in the concentration?
How will your work support the partner organization or their community?
Start Date
*
-
Month
-
Day
Year
Date
End Date
*
-
Month
-
Day
Year
Date
Anticipated total work hours
*
Submit
Should be Empty: