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Home
» Renewal Intership Site Application
Renewal Intership Site Application
This form is for Internship Sites who have been approved for 1-year or provisional status in the past and they want to apply to stay as an active Internship site for another year.
Organization / Church:
*
Address:
*
City:
*
State:
*
Zip:
*
Country:
Phone:
*
Fax:
Internship Supervisor:
*This individual will be the on-site supervisor and contact person for the internship.
Supervisor's Education:
Position/Title:
Supervisor’s e-mail address:
Internship Details
Internship Term:
Summer
Fall
Spring
Other
*Check all that apply
Internship Ministry Area:
General
Children & Family
Music
Youth
Other
*Check all that apply
Your organization will provide: (Fill out all that apply)
Salary:
$
Amount: $_____ per ______
Stipend:
$
Amount: $_____ per ______
Expense Reimbursement:
Please provide details.
Housing:
Yes
Scholarship/Offering/Bonus:
$
Estimated Amount: $_____
Other:
Please provide details
The intern(s) are expected to provide:
Own housing
Own transportation
Own expenses
Additional internship costs / fees
Other
*Check any that apply
If "Additional Costs" or "Other":
Please provide estimated amount and/or details.
Do you have an intern or interns selected?:
Yes
No
If you already have an intern or interns selected:
Name(s):
If you are looking for an intern or interns:
How would you prefer to select an intern or interns:
Post on website
On-campus interviews
Phone interviews
Interviews at your location
Other
If other:
Internship Fair
Would you like information about the Internship Fair that will be take place Fall Semester(November) 2011 :
Yes
No
Do you agree to our terms:
Yes
No
Our organization agrees to provide a quality educational experience through an internship opportunity in conjunction with North Central University’s (NCU) academic requirements. We will work with the NCU internship director by meeting the expectations and requirements outlined in the current internship manual, course syllabus, and learning agreement. This includes but is not limited to mentoring the intern, allowing active participation in the appropriate professional field, supervising assignment requirements, and meeting reporting deadlines.
Submission of this form indicates acknowledgment of and agreement to the policies, procedures, and requirements of NCU’s Internship program.
