UNIVERSITY OF MAINE AT AUGUSTA

Internship Proposal Template
Computer Information Systems

1. Student information

Name:	SSN:
Academic Program: Associate Degree Bachelor Degree

Check one: CIS280 CIS380 CIS480

2. Internship sponsor information

Name of organization:

Name of internship mentor/supervisor:

Telephone Number:

E-mail Address:

3. Faculty/Sponsor

Name of faculty mentor:

4. Internship proposal

Anticipated starting date:

Anticipated completion date:

4.1 Brief project description:

4.2 Learning objectives:

4.3 Methodology:

4.4 List of resources:

4.5 Collaboration with others:

4.6 Evaluation:

Grading Method (choose one) Letter Pass/Fail Audit

5. Approval signatures:

Student ___________________________________________________________			Date__________

Sponsoring Organization's Mentor __________________________________			Date__________

Faculty Mentor ____________________________________________________			Date__________

Student Advisor (if not faculty mentor)____________________________			Date__________

Division Chair (degree program) ___________________________________			Date__________

Approved by _______________________________________________________			Date__________

For the Division of _______________________________________________			Date__________

Chief Academic Officer ____________________________________________			Date__________