Form

Application for Internship, Practicum or Field Study
Directions:
1. Complete the following information and click " Submit " at the end of the application.
2. Print and sign the application that appears on your screen after submission. (A copy will also be e-mailed to you for your records).
3. Obtain the signature of the faculty member who will be supervising and grading your your internship or field study.
4. Return the signed application to the Registrar's Office (Duffy 112) by the last day of Add/Drop to have it added to your schedule.
5. A $50 late registration fee may be imposed for submitting this application after the Add/Drop deadline.
Note about Non-Credit internships:
While not required, students are encouraged to use this application to note that they are taking an internship on their own for no credit. In this case, the application does not need to be approved nor returned to the Registrar's Office.

However, students completing non-credit internships who wish to apply for Stonehill Summer Housing are required to complete this application, have it signed by Career Services, and then submitted with the summer housing application to Office of Residence Life.
Personal Information
Full Name*
First Name Last Name
Student I.D.*
Cell Phone Number*
- Area Code Phone Number
E-mail*
Class Year*
Major*
Major 2 (if applicable)
Minor (if applicable)
Course Information
Semester*

Fall Spring Summer for Fall Credit (3 credits max.) Non-Credit Summer Internship
Year*
Course Number*
Credits*
Note: The following hours on site are required in addition to an academic component as determined by the Faculty Internship Moderator:

No Credit internships:
While not required, students are encouraged to use this application to note that they are taking an internship on their own for no credit.
Students who apply for Summer Housing are required to submit this application even if doing an internship for no credit.

To qualify for 3 credits :
Minimum of 112 hours (8 hrs./week over 14 weeks avg.) – most Depts.
Minimum of 168 hours (12 hrs./week over 14 weeks avg.) – Business

To qualify for 6 credits : (Fall and Spring semesters only)
Minimum of 224 hours (16 hrs./week over 14 weeks avg.) – most Depts.
Minimum of 336 hours (24 hrs./week over 14 weeks avg.) – Business

To qualify for 9 credits : (Fall and Spring semesters only)
Minimum of 420 hours (30-35 hrs./week over 14 weeks avg.) - All Departments

Please note that student may earn a maximum of 3 credits for a Summer or summer/Fall split internship.
Faculty Moderator*
First Name Last Name
Are you applying for other internships, Practicum or field studies for the same semester?*

yes no
Internship/Field Study Placement Information
Organization Name*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Supervisor Salutation*
Supervisor Name*
(If proper title does not appear on drop-down menu, include in name field)
Supervisor Phone*
- Area Code Phone Number
Suprvisor E-mail*
Will you be compensated for this work?*

yes no
Weekly Amount $
Hours /week*
If known, start date
/ Month / Day Year
Describe the duties that will be assigned to you:*
Describe the learning outcomes that will result from this internship/field study experience:*
Should be Empty:

Application for Internship, Practicum or Field Study

Personal Information

Course Information

Internship/Field Study Placement Information