DEPARTMENT OF COMMUNICATION STUDIES
COM 499 INTERNSHIP APPLICATION
Complete this form, attach a copy of your unofficial transcript printed from MyUNLV, and
submit a copy of the entire application packet to the internship coordinator for approval.
Applications may be submitted to the Communication Studies office or directly to the coordinator
as a hard paper copy or via email. Once approved, the COM office staff will contact you with course
enrollment information.
Name:
Class Standing: Choose class standing
NSHE ID:
Mailing Address:
Phone:
@unlv.nevada.edu
RebelMail address:
Overall GPA (minimum 3.00 required):
Major:
Emphasis (optional):
Minor:
Semester of internship: Choose semester
Location of internship
Supervisor’s Name
Phone
Email
List 4 upper-division COM courses taken relevant to the proposed internship.
Course Title
Semester & Year taken
Instructor
Grade Earned.
1.
2.
3.
4.
Description of internship. Describe, in your own words, the responsibilities, objectives, and
intended work hours/days for your internship. Attach the official description of the internship
(from the organization) when you submit this application.
Explain how your COM Studies coursework can be applied to understand and analyze your
internship experiences based on what you know about the internship at this time.
For Office Use Only
Date received:
Received by:
Official Internship description included? YES
Transcript included? YES or
NO
or
NO
Internship Coordinator Only
Approved? YES or
NO
Date approved:
RELEASE OF LIABILITY
A. I
(Student name -- hereinafter referred to as Student) am about to participate in an
internship program with
(name of organization). Said internship program may require my
participation in activities on the campus of the University of Nevada, Las Vegas and in activities
outside of the campus. The University is under no obligation nor does it undertake such
obligation to discover or know the nature of any and/or all activities, hazardous or otherwise,
which may occur during this internship.
B. To the extent authorized under the laws of the State of Nevada, the University shall not be liable
for any loss, damage, liability, cost, or expense to the person or property of another either caused by
or caused to the Student (named above), except as may be directly attributable to the negligence of
the University, its officers, employees, and agents. The Student (named above) agrees to
indemnify and hold harmless the University, and any of its officers, employees, agents, and students
from any loss, damage, liability, cost or expense to the person or property of another caused by the
Student (named above).
C. I hereby affirm that I have become, or will become, the beneficiary of an insurance policy that
will adequately compensate me for any injury incurred as a result of my participation in the
Internship Program specified in Paragraph A above.
Witness my signature this
day of
(MONTH), Select Year,.
Student signature: ___________________________________
Name:
Internship Coordinator: ______________________________
Name: Tara G McManus
Please have the Administrative assistant make a photocopy of this document for your
records after the internship coordinator has signed this form.
Note to Internship Sponsors: The Student’s copy of this completed application form and Release
of Liability form indicates that the Student will receive academic credit upon successful completion
of this internship. This copy serves in lieu of a litter from the Internship Coordinator.