Internship

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Architecture Department Cooperative Education/Internship APPLICATION STUDENT  INFORMATION   _____________________________________ Student Name

________________________________ Student ID Number

___________________________________________________________________________ Student’s Co-op/Internship Address, City, State, Zip Code

____________________________ Student Phone Number [email protected] Student Email Address

No

Are you an International Student? Yes

If yes, you must meet with an International Programs Advisor.

EMPLOYER  INFORMATION   ____________________________________________________________________________________________________________ Employer Name ____________________________________________________________________________________________________________ Employer Address, City, State, Zip Code ___________________________________________________________ Co-op/Internship Supervisor Name

___________________________________________ Supervisor Position

___________________________________________________________ Supervisor Telephone Number

___________________________________________ Supervisor Email Address

CO-OP/INTERNSHIP  INFORMATION   Co-op/internship location if different from above: _____________________________________________________________________________________________________________ Address, City, State, Zip Code Start date: _____________ Finish date: ______________ Check if you need studio credit (5 units): Summer ARCH 485

Fall ARCH 451

Winter ARCH 452

Spring ARCH 453

How many total course units do you need (including studio units if applicable)? _________ Planned work schedule: Hours per week _____ x number of weeks _____ = total hours _________ Are you being compensated for this co-op/internship? Yes If yes, the rate is $ _____________ per hour

CONTINUED  ON  BACK  

week

No month

STUDENT AGREEMENT FORM continued Have you begun the Intern Development Program (IDP)?

Yes

No

Whether or not you have begun IDP, please review the "IDP Guidelines”(http://www.ncarb.org/~/media/Files/PDF/ Guidelines/IDP_Guidelines.pdf) with your proposed co-op/internship supervisor, identify the IDP categories and areas that you can expect to explore, and attach an outline to this form.

SIGNATURES   "I accept this co-op/internship as authorized by the Architecture Department." __________________________________________________

_______________

Student Signature

Date

"This student is my apprentice, and I agree to support his/her professional education and progress to licensure while working under my supervision.” __________________________________________________

_______________

Co-op/Internship Supervisor Signature

Date

"This student is in good academic standing and the co-op/internship meets the requirements of the Architecture Department." __________________________________________________

_______________

Faculty Advisor Signature

Date

"I have consulted with this student about employment visa options and/or the international study abroad travel process." _____________________________________________ International Center Signature

________________________________________ International Center Name

A Letter of Recommendation for Academic Training Authorization is required Yes

______________ Date

No

The information below is to be completed by the Staff Coordinator and provided to the student. Registration Information: Quarter/Year

Course Numbers

Permission Numbers

Units

_________________

_________________

_________________

_________________

_________________

_________________

_________________

_________________