(Number of overall credit hours completed to date toward your degree)
Your answer
Cell Number
(include area code)
Your answer
Email Address
Your answer
# Internship Credit Hours & Semester
Four credit hours of internship = 15-20 work hours per week; two credit hours = 7-10 work hours per week. For semester, state Summer I, Summer II, Summer 12-week, Fall, Spring (etc.) and the year.
Your answer
# Internship Work Hours per wk
Your answer
Company
Your answer
Contact Name
(your internship supervisor's name at the company)
Your answer
Contact's Email
Your answer
Contact's Phone
Your answer
Company's Street Address
Your answer
Agreement
I understand that it is my responsibility to write a summary report of my internship experience at the end of the semester and submit it to Juliet Davis (juliet.davis@ut.edu) as part of the requirement for satisfactory completion of this internship, and that failure to submit this report could result in failure of the internship for credit.