Internship Approval Form

CBA Graduate Programs
Internship and Community and Industry Graduate
Assistantship Approval form
Date: _______________
ID# ____________________________________
First Name: ______________________________
Last Name: _____________________________
UA Email Address:
________________________________________________________________
Country of Citizenship: ________________________________________________________________
If you are not a US citizen, what is your visa status? _________________________________________
Program and Concentration: _____________________________________________________________
First Semester Enrolled: _________________________________________________________________
Have you completed all Gateway or Foundation courses for your degree?
Student Signature:
___ No
___ Yes
________________________________________________________________
For Graduate Programs Staff Only
Is the student:
provisionally admitted? (provisional students are not eligible)
on probation? (students on probation are not eligible)
in good standing with a GPA >= 3.0? (GPA < 3.0 = ineligible)
an international student who has completed the required two semesters of full-time
enrollment? (one semester for domestic students).
eligible for an Internship?
eligible for a CIGA?
Yes
No
Semester(s) of Internship Eligibility (actual enrollment will be limited to one semester per student).
Notes:
Advisor Signature:
_______________________________________
Processing: SCAN to Nolij, Student and Internship Coordinator.
Date: _____________
P:\ST Forms\Dept. Forms\Internship Approval Form