ACADEMIC INTERN REQUISITION FORM

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					                                                        ACADEMIC INTERN REQUISITION FORM

School/College:                                                          Academic Department:
All Academic Interns must conform to Workload Guidelines, which define a full-time appointment as providing, on average, 20 clock hours of work per week for
a semester. If approved by a designated university officer, fractional appointments of 5, 10 or 15 clock hours per week may be requested with proportionate levels
of stipend and tuition.

Proposal to Establish Academic Internship
  Semesters Projected (Place X)              Fall            Spring        Summer I/Summer II                Year: 200          -



        Proposed Academic Internship Title:
        Role of Faculty Supervisor:
        Briefly describe duties that are related to the instructional program in school/college (that fall outside definitions of TA/RA):




        Outcome/Performance to be monitored:
                                                           On Average            Hours/week       x 1.00 =                Calculated Clock Hours
        If External Funding Used, Cost Center/Account(s) to be charged:
        If Internally Funded by School/College, Cost Center/Account(s) to be charged:

Department Chair Signature: (Name)

                                (Signature)                                                                       Date:

Designated University Officer or Designee: (Name)                                                                 Approved:          Denied:

                                                    (Signature)                                                   Date:

Academic Intern Assigned (Name):                                                                  Degree/Program:

Student ID Number:                       -          -

				
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