School of Architecture, Fine Arts, & Design

INTERNSHIP ACCEPTANCE FORM

FD 446 INTERNSHIP LAB

STUDENT INFORMATION (Please print or type) Academic Year:

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Student ID No. _________________________________ o 1 st semester
Family Name _________________________________ o 2 nd Semester
Given Name _________________________________ o Summer
Middle Name _________________________________
Mobile No. _________________________________ Have you completed all 3 rd year subjects?
Home No. _________________________________ o Yes
Email Address _________________________________ o No

INTERNSHIP INFORMATION

Company
Name:________________________________________________________________________________
Company
Address:_____________________________________________________________________________
Telephone
No.:_________________________________________________________________________________
Email
Address:_______________________________________________________________________________
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Supervisor’s Name &
Title:_______________________________________________________________________
Date of Employment:
Starting Date: ___________________________________ Ending Date:
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Average No. of Hours Per Week:
__________________________________________________________________

Job Description:
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(Please print or type, attach extra sheets if necessary)

Approvals:

Student’s Signature ______________________________ Date _______________________________

Signature of Employer ____________________________ Date _______________________________