UNCW FILM STUDIES DEPARTMENT INTERNSHIP APPLICATION APPLICATIONS ARE NOT CONSIDERED COMPLETE WITHOUT A DEGREE AUDIT, SIGNED PERMISSION TO ENROLL FORM AND RESUME ATTACHED. RESUME MUST ALSO BE EMAILED AS A PDF.FILE TO: linehant@uncw.edu For assistance with your resume, please contact: UNCW Career Center - Fisher University Union. INTENDED SEMESTER OF INTERNSHIP: _____________________________ _____________________ (SPRING, FALL, SUMMER I, SUMMER II) (YEAR) You may direct any questions to: Terry Linehan, Internship Director, 910-962-2231, linehant@uncw.edu, KI 106B 1. You will be charged an $18 liability insurance fee for EACH production course (including internships) for which you are enrolled. Once you register for the course(s), this fee will automatically post to your student account as a tuition fee, and is due with your tuition payment according to university policy. Please print legibly. Full Name: __________________________________________________________ Student ID #: ___________________________ Address: ________________________________________________________ Phone: ___________________________________ ________________________________________________________ E-mail address: ____________________________ Current GPA: ____________ Class Year (Junior, etc.): __________________ Expected graduation date: ______________________ Major: __________________________ Minor: ___________________________ Please list any internships or DIS courses completed, or in progress: Preferred internship sites (list specific agencies in order of preference): 1. ________________________________________________________________________________________________________ 2. ________________________________________________________________________________________________________ 3. ________________________________________________________________________________________________________ Do you have any physical impairments, disabilities, or medical conditions of which we should be aware?: ____ Yes ____ No If yes, please explain briefly: Are there any particular activities or tasks that you are unable or unwilling to perform (heavy lifting, conducting business on telephones, etc.)? Please list: BY SIGNING BELOW, I PLEDGE THAT I HAVE READ, UNDERSTAND, AND AGREE TO FOLLOW THE “INTERNSHIP EXPECTATIONS” LISTED ON THE MAIN INTERNSHIP WEBPAGE UNDER “ESSENTIAL INFORMATION.” Student signature _____________________________________ Revised 06/15/11 Date: ________________________