Student Internship Application

Student Internship Application
Name*

First NameLast Name
UID*
U00012345
Memphis Email*
uuid@memphis.com
Mobile Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cumulative GPA*
Have you applied to graduate?*

YesNo
Please apply to graduate before completing application.
Semester of Internship*
240 hours required; may only be completed within the registered semester. Students must register for the course.
Course (Do NOT submit a permit request for these courses).*

ESMS 4605 - 6 hoursHCL 4605 - 3 hoursHCL 4605 - 6 hoursHLSC 4605 - 6 hoursPETE 4605 - 3 hoursPETE 4605 - 6 hoursNUTR 4605 - 3 hours
Areas of Interest and Goals for Internship*
Students are responsible for finding and securing an internship site
Post-Graduation Plan(s)*
Are you First Aid/CPR certified?*

YesNo
Upload First Aid/CPR certification (include visible expiration date)

Browse Files
Files types accepted: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, jpg, jpeg, png Cancelof
Upload your resume*

Browse Files
Files types accepted: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, jpg, jpeg, png Cancelof
Resume must be formatted according to the Sample Resume for CHS students.

Resume building and career enhancement is provided by Fonda Fracchia: 901.678.5160 | ffacchia@memphis.edu
Status of Internship Site*

Site contacted and internship confirmed- ready to complete Part 2Site has conducted an interview and waiting for site approvalIn the process of pursuing sites of interest
By signing, you understand the requirements for your internship:
- All majo coursework has been completed with a passing grade of C- or higher for my CHS major.
- I have applied for graduation.
- I am responsible for finding and seeking approval for my internship site.
- My internship will be outside of my current employment.
- It is my responsibility to complete all site-required documentation before beginning my internship (background check, drug screening, immunization records, etc.).
- My internship hours may only be acquired during the semester (not before).
I understand the above requirements*

YesNo
Signature*

Clear
The University of Memphis is an Equal Opportunity/Affirmative Action University. It is committed to the education of a non-racially identifiable student body.
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