APPLICATION FOR INTERNSHIP/ADVANCED FIELDWORK
Name:
Date:
Local Address
Street:
City, State, Zip:
Phone:
E-mail:
Academic Information
Semester/Year in Which You Plan to Graduate:
Semester in which you plan to Intern/Fieldwork:
Name of Your Academic Advisor:
Major:
Minor (if applicable):
A student should have completed the required courses listed below and
earned a cumulative grade point average of 2.5 in these courses. An average
grade of B or better must also have been earned in Service Learning I and II.
No student on academic warning may apply for internship. Students who do
not meet the above requirements must enroll in Advanced Fieldwork.
Section I
Directions: On the next page is a list of the required Recreation Management and Outdoor
Adventure Leadership courses. For each course listed for your major, check the appropriate
box indicating whether you have taken or are currently registered for the course. In
addition, list any additional courses that you have taken that have a RLS- prefix. Lastly, you
will need to download the GPA calculator spreadsheet (link can be found at:
http://www.ithaca.edu/hshp/explearning/rls/) and fill in the grade that you obtained in each
course that you have completed. After entering your grades, print a copy of the document
and attach it to this application. Applications will not be accepted without a copy of this
information included.
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Required Recreation Management & Outdoor Adventure Leadership Courses
Status
(check one)
Taken
Registered
Course
History and Philosophy of Leisure RLS-10300 or
Leisure and Society RLS-10100
Fundamentals of Leadership RLS-10500
Understanding Disability RLS-12500
Program Planning RLS-23200
Design and Operation RLS-23500
Service Learning I RLS-24800
Administration and Supervision RLS-33000
Research Methods RLS-33200
Inclusive Recreation and Diversity RLS-34000
Service Learning II RLS-34800
Seminar: Professional Development RLS-45300
Elective 3-credit RLS-prefix theory courses
(1)
(2)
(3)
(4)
(5)
(6)
Section II
List below any specific agencies which you are considering or investigating.
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Signature
I give my advisor, internship coordinator, and internship supervisor
permission to discuss my academic performance and professional behavior
with agency representatives.
Student Signature
Date
When completed, this form must be submitted to the internship coordinator.
***************************************************************
For Office use only
Date Application Received:______________
Approved / Disapproved
Approved / Disapproved
Dept. Chair, RLS
Internship Coordinator
Date
Date
Comments:
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