Undergraduate Internship Application Form

The Department of Kinesiology requests that students discuss a possible internship with three different agencies before submitting this application. If you have any questions about applicable internship sites, students are advised to contact their academic advisor.

Complete all sections as described in the form below.

- indicates required field

Name

Degree and Concentration Area

UNA Email

Preferred Phone Number 555-555-5555

UNA L Number

Home Address Street, City, State, Zip

Name of Academic Advisor

Requested Internship Semester

Anticipated Graduation Semester

Will you have completed all your coursework for your degree prior to the start of your internship Yes or No. Contact the UNA intern supervisor if you have remaining coursework. 256-765-4743

Are there any special circumstances that should be considered when assigning you to an internship site

Current Cumulative GPA Check Degree Works

Major GPA Check Degree Works

Please provide the following information for the three agencies that you have contacted for possible placement.

Agency 1 information List agency name, contact person name, phone, and email.

Agency 2 information List agency name, contact person name, phone, and email.

Agency 3 information List agency name, contact person name, phone, and email.

Entering your full name here affirms that you have no prior affiliation with the agencies listed and that all information presented is true Failure to provide truthful information may cause delays in internship placement

Please make sure all required fields have been filled out correctly.

Submission received!

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