Application for International Internship Grant

Name:              ______________________________________________

Class:               _________

1.         Internship for which applying:

1st choice:  Name of Organization: __________________________________

Brief description of internship assignment: ____________________________

             _________________________________________________________________

__________________________________________________________________

2nd choice:  Name of Organization: _____________________________

Brief description of internship assignment: ____________________________________________________________________________________________________________________________________

2.         Foreign Language Skills: ____________________________________________

            Note:  For internships requiring foreign language skills, a foreign language

            evaluation is required.

3.         Previous Foreign Travel/Study:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

4.         Have you applied for any other internship (e.g. Shepherd Program, Washington Seminar or Environmental Studies)?

            ________________________________________________________________

5.         Budget:  Please specify projected expenses for completing proposed internship, amount being requested from Global Stewardship (up to $3,000), and funding being requested or available from other sources to make up the difference, if any.

                        Travel:                          $_________

                        Room & Board:            $_________

                        Other:                           $_________

                                                                                                Total:  $__________

                        Amount requested from GS                                          $__________

                        Difference, if any                                                           $__________

6a.       Do you have a passport which will remain valid throughout your stay?

            □ Yes   (Include a photocopy of the front page)

            □ No

6b.       Will you require visa and/or work permit for your proposed internship?

7.         Do you have health insurance which would cover your overseas stay?  You must submit proof of adequate insurance that includes evacuation and repatriation.  We require that you get supplemental insurance before you leave, if necessary.   Please contact the Center for International Education for details.

8.         Please attach the following:

            a)         Resumé

            b)         Statement of interest (500-800 words)

            c)         Letter of invitation from internship organization

            d)         Copy of your transcript

            e)         Two faculty recommendations.