Unpaid/Underpaid Internship Support Form

Internship Support - Student Application
Name*
First Last
Preferred or chosen names welcome
Email*
Student ID*
Major*
Minor (if applicable)
College*
Class Year*
- 1st Year
- 2nd Year
- 3rd Year
- 4th Year
- 5th Year
- Graduate Student
Are you Pell Grant eligible?
The Pell Grant is the largest federal grant program offered to undergraduates and is designed to assist students from low-income households.
We will be looking at your financial aid package. If your financial aid package will not accurately represent your financial need, please explain why here:
What is the highest level of education completed by either of your parents or those who raised you?
- Did not finish high school
- High school diploma/G.E.D.
- Attended college but did not complete degree
- Associate's degree (A.A., A.S., etc.)
- Bachelor's degree (B.A., B.S., etc.)
- Master's degree (M.A., M.S., etc.)
- Doctoral or professional degree (Ph.D., J.D., M.D., etc.)
- Prefer not to answer
How did you hear about the fund?*
How many internships have you participated in related to your current area of study*
- None
- 1-2
- 3-4
- 5+
- Unsure
An internship is a professional learning experience that offers meaningful, practical work related to a student’s field of study or career interest.
Internship Information
Organization Name*
Organization Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Internship Start Date*
MM slash DD slash YYYY
Internship End Date*
MM slash DD slash YYYY
Hours per week*
Hourly pay (if applicable)*
Internship Description and Responsibilities*

Written Responses
Please explain why this internship is important to you and how it fits into your professional goals and career path.*
Please explain how this money will help to make your internship financially possible.*

Further Information
Please provide a detailed breakdown of your budget during your internship, including the amount of money you are requesting (up to $4,000)*
Please disclose any additional funding you are receiving to support your internship*
*
- I understand that if I am awarded this financial support it may impact my financial aid and/or have tax implications. By checking this box I acknowledge it is my responsibility to consult Financial Aid to determine any such impact.
Please submit an intership offer letter/email confirming you have received an offer.*
Max. file size: 30 MB.
This can be an image, PDF, or other type of file.
Name
This field is for validation purposes and should be left unchanged.

Step 1 of 3

Internship Support - Student Application

Internship Information

Written Responses

Further Information