INTERNSHIP ACCEPTANCE FORM

GRADUATE DIVISION

Department of Sociology ● IUPUI

425 University Blvd. ●CA 303 ●Indianapolis, IN 46202-5140

Telephone: 317-274-8981 ● Fax: 317-278-3654 ● Email: sociolog@iupui.edu
● Web:  http://www.iupui.edu/~slasoc/

 

Section A of this form is used to coordinate and clarify the expectations and responsibilities of the student, the agency, and the faculty committee chair

 

 

Section A

STUDENT INFORMATION – completed by student

Student’s Name::      ________________________________________________________

Internship Title: ____________________________________________________________
_________________________________________________________________________

Committee Chair:  __________________________________________________________

Committee Member: ________________________________________________________

I certify that the above named student has satisfactorily completed the internship requirements for the Masters Degree in Sociology.

 

Committee Chair:  ___________________________________       Date: _____________

Member:  _________________________________________        Date: _____________

Section B
CERTIFICATION OF STUDENT’S FULFILLMENT of all the requirements for a master's degree, by 3 members of the Graduate Faculty.

Signatures required:
1) Director of Graduate Studies:
                      ___________________________________         Date:_____________       
Printed Name:  ___________________________________
2)Faculty Two:  ___________________________________       Date: _____________
Printed Name:  ___________________________________
3) Faculty Three: __________________________________       Date: _____________
Printed Name: ____________________________________