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
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