Cooperative Education & Departmental Internship Application

Cooperative Education Application (Upper Level Elective Credit)

Cooperative Education is located on the 3rd Floor of Reed Library in the Career Services Office.

If you wish to participate in Cooperative Education, please fill out the form below. Contact the Career Services Office for more information. (*Indicates required fields)

First Name:
Last Name:
Address:
City:
State:
Zip Code:
E-mail:
Phone:
Student ID Number:
Degree you're pursuing:	Bachelor of Arts Bachelor of Science
Major/Minor:
Total number of credits completed thus far towards your degree:
Credits attempting (enrolled in) this term:
Overall GPA:
Anticipated Graduation Term:
Anticipated Graduation Year
Placement Term (when you want to do cooperative education):
Enter the number of credits you wish to receive for this experience. (Subject to approval based on number of hrs worked and type/depth of assignment. You can earn 1 credit for 50 hours of work.)
Describe generally what you hope to gain from this experience:
Are you a U.S. citizen or permanent resident (green card holder)?	Yes No
If no and your worksite is off campus, you MUST consult with the International Programs Office at 247-7650 to make sure your paperwork is in order. The immigration approval paperwork must be submitted to Career Services before you can register for either Cooperative Education or internships.
Photo and Comments Release Please check the statements below that authorize the Cooperative Education staff to use images of you and/or comments from you in presentations, posters, or other publications promoting the program.
I authorize the Coop Ed Staff to use images of me or my work site in promotional materials or programs. \|I authorize the Coop Ed Staff to use experpts from my reports, other writings, or interviews in promotional materials.