IUPUI Department of Sociology

R494 Internship Interest and Eligibility Form (1/07)

Date: __________________________________                Student id: _______________________________

I am interested in an internship for _____________                      Credits desired in R494: ________ (3-6)

                                                    Semester/year

 Name:________________________________________    E-mail: ___________________________________

Address: _______________________________________________________________________________

Phone: __________________________________Cell: ___________________________________________

Major: ___________________________________Minor: _________________________________________

Number of credit hours that you will have completed in sociology by the start of the internship:  ____________
                                                                                                                                                          (12 required)

Number of credit hours that you will have completed in sociology at IUPUI by the start of the internship: ______
                                                                                                                                                             (6 required)

 Estimated grade point average overall:  ______ ( 2.5 required) 

Estimated GPA in all sociology courses taken:  ______  (3.0 required)

What type of work are you interested in?  ______________________________________________________

What relevant courses have you taken?   ______________________________________________________

_______________________________________________________________________________________

Do you have any agencies/organizations in mind?  (Students cannot intern where they presently work for pay.)

 __ no  __yes > Which ones?   ______________________________________________________________

Would you be able to undertake an unpaid internship?  __ yes    __ no

An internship takes 10 hours a week (for 3 credits, more for more credits).  Do you have blocks of time free from school and paid work that you can devote to this?   ___ yes __ no

Are you taking this internship to fulfill your requirements for the capstone in Sociology?  __ yes  __no

If you want to do this for capstone credit

Will you have completed at least 80 college credits by the start of this internship?  ___ yes   __ no

Will you have completed a course is sociological theory, a course in methods, and at least 4 other courses?    __yes       __no

You need two faculty members to review your capstone work.  Indicate your preferences below. 

 ________________________________________                 _______________________________________