University of California, Santa Barbara
Department of Geography
Internship in Geography: Geography 193
Academic Year 2017 – 2018
Internship Application
Please review the internship requirements listed in the course syllabus. Return this completed form with signatures from your internship supervisor (or faculty supervisor) to Patty Murray after you have Dr. Vena Chu sign it. Patty will then give you the approval code so you can add this class, by the Add/Drop deadline for the quarter you wish to enroll in 193.
To be completed by the student: Quarter: ____________________________
Name:_________________________________________________________________
Phone: _______________________________
Local Address:_____________________________________________________________
______________________________________________________________________
Perm Number: _____________________________ G.P.A. _________
Faculty Sponsor: (same as Faculty Supervisor if Internship in UCSB Geography Department)
_________________________________________________________________
Geog. 193 Units: ___________________________
To be completed by Student or Agency Supervisor:
Agency Supervisor: (or Faculty Supervisor) _________________________________________________________________
Phone Number: _____________________________
Agency Name:__________________________________________________________
Agency Address:________________________________________________________
______________________________________________________________________
Requirements:
By Add/Drop: Resume _______ G.P.A._______ G.P.A. Waiver _______
Internship Application _______ Interim Report _______ Student Final Report _______