4/12/2020
College of Arts and Sciences
Application for Enrollment in Cooperative Education Internships
Liberal Studies Program Co-op
To qualify for enrollment in a Cooperative Internship course for credit, the Arts and Science student must
meet the following requirements:
1. Overall GPA of 2.5 or higher for all coursework
2. Completion of 45 credit hours.
Please Print
Last Name
First Name
Middle Initial
Street Address
E-mail Address (university email address)
City, State, Zip
Phone (home/work)
Enrollment School: AS
Student ID#
Year/Term: _______ _______
Credit Hours: _______
__LBST____
Dept. Code
___400__ _______
Course Section
Course Topic (if applicable – see program advisor for more information)
_________________________________________________________________
(24 character limit)
Co-op Site _____________________________________________________________________________
Project Plan (Course Objectives – these objectives should complement the learning outcomes described in
your proposal ):
Instructor’s Name
Instructor’s Signature
Supervisor/Co-op Site
Date
Supervisor’s Signature
Date