Internship Approval Request

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1 STEP 1: OPTIONS 2 STEP 2: INTERNSHIP COURSE SELECTION 3 STEP 3. SPECIAL CONDITIONS 4 STEP 4. SITE & SUPERVISOR INFORMATION 5 STEP 5. STUDENT INFORMATION 6 Complete

PLEASE FOLLOW ALL INSTRUCTIONS CAREFULLY TO AVOID UNNECESSARY WORK FOR YOURSELF AND YOUR ACADEMIC INTERNSHIP SUPERVISOR.

This form is used to seek approval of an academic internship or practicum experience.

Make the appropriate selection below and follow the directions that appear.

STEP 1: OPTIONS

IMPORTANT: Please read carefully to ensure you make the correct selection.

Please select one of the options below to proceed with this form. *

I will be interning as a COPE Health Solutions Clinical Care Extender

I found my academic internship in Titan Connection and/or my internship is already in Titan Connection

I DID NOT find my internship through Titan Connection

I have not yet received an offer for an internship

A SECURED INTERNSHIP IS REQUIRED TO COMPLETE THIS FORM

Please apply for and secure an academic internship for your proposed semester/term. For further instructions, locate your departments respective Academic Internships Instructions Card and review the "Apply" section of the card.

For further questions, contact CICE at 657-278-3746.

!! DO NOT CONTINUE WITH THIS FORM AT THIS TIME. !!

CONGRATULATIONS! YOU ARE READY TO COMPLETE THE CICE PLACEMENT PROCESS.

Please ensure your internship site and position are approved using the link below. Enter in either the name of your organization or your position title.

>> ACADEMIC INTERNSHIP APPROVAL VERIFICATION

If BOTH the name of your organization AND your position title appear in the results, then DO NOT proceed with this form. Return to your CICE Instruction Card and continue from Step 3.

If EITHER your site and/or your position DOES NOT appear in the verification results screen, click "Next Page" below and continue with this form.