For Office Use: Approved date:___________

Course & Credits____________

Today's Date:_____________________________________________________________
Student Name: ____________________________________________________________
Student Email:____________________________________________________________
Student Phone #:__________________________________________________________
UIN:_____________________________________________________________________
Name of Internship Organization:______________________________________________
Address: _________________________________________________________________
Name of On-site Supervisor:_________________________________________________
Telephone of Supervisor:_____________________________________________________
Email of Supervisor: ________________________________________________________
Start/End dates of Internship: ________________________________________________
Number of Hours of Work/Week: ______________________________________________

Sample Internship Proposal

[Use this form as a Guide to develop your Proposal]
This Proposal for Credit for your Internship experience should only be completed
and submitted to the Internship Office AFTER you have been offered and accepted
a position.

Background [Please note those significant and substantial experiences and educational
opportunities you have had in the past or are currently engaged in that relate to your
Communication major and your pursuit of a career in a communication related field], for
example:
My background in communication-related fields is derived mainly from my [please list extracurricular activities]. I have had coursework in [please list applicable coursework]
My hands-on experience [please note applicable experiences in employment and volunteer
activities] lies primarily in the areas of ..
Educational Objectives
The internship experience I propose .. [please note what specific responsibilities in the
internship you will be involved in. Also, why and how this particular internship will assist
you in your career goals] More specifically, it will help accomplish the following educational goals:
1. List all educational goals
2.

For Office Use: Approved date:___________

Course & Credits____________
Internship Activity [Please note the specific job requirements; job description]
I will intern approximately [insert number of hours/week] in the [insert specific location of
internship responsibilities] My activities to accomplish the above goals are as follows:
1. List All activities and work requirements
2. Etc.
I will be responsible to [insert supervisors name and contact information] who will be my
internship coordinator at [Name of organization], and to [Name of faculty member who will be
sponsoring you. If you earn credit through the Internship Program Office, then Dr.
Faughns name goes here] who will be my faculty sponsor at the University of Illinois, Department
of Communication; and, who will oversee my academic assignments and provide a grade at the end of
the term. If this internship proposal is approved, the specific assignments and the amount of
academic credit in CMN 304 will be determined in consultation with my faculty sponsor.
[Note: Specifics to be determined in consultation with faculty, examples are: a weekly
journal of work activities and observations as they relate to theory; a formal paper (8-10
pages) which integrates experience, applied theory, and perceptions of the job; a portfolio
of work/product samples; an interview protocol and data from interviews conducted with
organization personnel to obtain information about their jobs and background; a
publishable abstract as a result of reading a business book on a related topic]
As a requirement of the Internship experience I will also submit at the end of the semester:

The Intern Evaluation form provided by my faculty sponsor and/or the Internship Office and
completed by my on-the-job supervisor. I will review the evaluation with my supervisor and
then turn it in to my faculty sponsor with my other assignments.
The Employer Evaluation form to be completed by me on the company/organization with
which I have worked as an intern. I will submit this form to the Internship Office.

If I have any questions, concerns or need assistance I will be able to contact the:

Internship Office at: 4086 Lincoln Hall, 702 S. Wright St., Urbana, Illinois, 61801; comminternships@illinois.edu; 217-333-4383. Or, my
Faculty Sponsor [insert name and email address].