Important: Please read "Internship Guidelines and Requirements" before completing this form. Note also that you are granting permission to photocopy your application materials for possible submission to internship sponsoring agencies as part of the selection process. Any concern you may have with this should be discussed with the Graduate Director.

Today's Date: ____/____/____

o Graduate Internship application

Application for:

o Fall Semester 19
o Spring Semester 19
o Summer Semester 19

Name: ___________________________________________________________________________________

(Last) (First) (Middle)

Social Security Number: _______ - _______ - _______

Local Address: ____________________________________________________________________________

(Street) (City) (State) (Zip)

Permanent Address: ________________________________________________________________________

(Street) (City) (State) (Zip)

Local Home Phone: _____________ Local Work Phone: _____________ Permanent Home Phone: ____________

Email Address: _________________________________

*If you have no phone, please provide a way that we can reach you directly.

Classification: o Second Semester o Third Semester o Fourth Semester

Overall GPA: ______ Expected date of Graduation: ______

Major Concentration Area: o Earth System Science o Human Dimensions o Techniques

Please rank the following Internship positions that you would most prefer (1 = MOST PREFFERED) _____ Applied Physical Geography _____ Cartography/ Map Related _____ Computer Mapping/ GIS _____ Environmental Planning and Management _____ Natural Resource Planning and Mgt. _____ Urban and Regional Planning _____ Land-use management and planning _____ Transportation Planning _____ Research Assistant _____ Other(s). Please describe: ___________________________________________

Please rank your agency/organization preference (1=MOST PREFFERED) _____Municipal/ City/ County _____Regional/ State/ Federal _____Private Sector _____Consultant (incl. non-profit) _____Comments:__________________________

Do you own or have ready use of a reliable vehicle for to- and on-the-job transportation? o Yes o No

Internship Location Preference: ______________

Would you be willing to commute more than 30 miles one-way? o Yes o No

Departmental Advisor: ______________________________________________________________________

If you have not yet selected an advisor, list that faculty member whom you plan to have as your advisor, or who is most familiar with your work.

Describe any relevant work or volunteer experience which might support your application (job/agency experience, skills, knowledge of methodologies, military experience, etc.):

Briefly, describe your career/advancement goals at this time.:

Have you already received any college level internship course credit?
o No o Yes If "yes" explain where, types of duties, and academic credit received:

List the course code and title of any classes (both geography and non-geography) that you have taken that are relevant to the type of internship that you are seeking.

List any computer skills that you have such as digitizing, computer mapping, GIS, programming, word processing, spreadsheets, database managers, etc.

I have read the "Internship Guidelines and Requirements."

____________________________________________________________

Student Signature/Date