Internship Information Form

If you see this don't fill out this input box.

*First Name

Middle Initial

*Last Name

*Preferred Email AddressEnter an email address where you wish to receive communications from IOGP.

*Cell Phone Number

*May IOGP text you at this number?

Yes

About Your Internship

*Internship Start Date

Internship End DateBest estimate is okay

*Name of Organization or Politician

Name of the Specific Department

*Title of the Intern Position

*Location of the Organization (City, State)

*Supervisor's Name

*Supervisor's Title

*Supervisor's Phone Number

*Supervisor's Email

*Briefly describe the internship responsibilities/duties as you understand them:

*Type of Internship

Working onsite at an office location

Remote/virtual only

Hybrid -Some onsite and some remote/virtual hours

*What will be your primary work location? (City, State)Where you will be living during your internship.

*Is your internship full-time or part-time?

Full-time

Part-time

*Indicate the approximate number of hours you will be working per week:

*Is your internship paid or unpaid?

Paid

Unpaid

*How much will you be paid? (Enter 0 for un-paid.)Please specify if your wages per hour, wages per week, wages per month, or wages per semester with your number (e.g. $1000/week or $5000/semester)

*Internship Verification: Do you give approval for IOGP administrators and/or the course instructor to contact your supervisor to verify your internship details?

Yes

USU Academic Credit

*Are you registering for academic credit for your internship?This is a variable credit course. Up to 9 credits maximum are available. Credits are calculated based on the total number of internship hours in the semester. 1 credit for every 40 hours worked. Your instructor will reach out to you with more information.

Yes

Not Applicable

*DC Seminar Course Credit: If you are interning in Washington, DC, do you plan to register for the 3-credit seminar course?There will be 6 seminars provided. If you are staying in USU’s subsidized housing, you are required to attend the 6 seminars whether or not you register to receive credit for them.

Yes

Not Applicable

*Utah Legislature Seminar Course Credit: If you are interning with the Utah State Legislature, do you plan to register for the 3-credit seminar course?There will be 6 seminars. You are required to attend all 6 seminars whether you register for credit or not.

Yes

Not Applicable

IOGP Travel Scholarship

*Are you applying for a travel scholarship?Travel scholarships are a flat amount per semester to assist with travel and/or housing expenses.

Yes

Not Applicable

If you answered yes, please complete the following application questions to be considered for the travel scholarship.

How will this scholarship help you financially?

How will this scholarship help you achieve your academic and professional goals?

Tell us about other financial resources you have for this semester?For example, other scholarships, grants, loans, or family assistance.

Please estimate your costs for housing and travel.

Total Housing Cost per Semester

Total Travel Costs for Round Trip Travel

Total Cost of both Housing and TravelAdd the previous two amounts together and put the total here.

Housing in Washington, DC

*Would you like to stay in USU's subsidized apartment housing in Washington, DC?

Yes

Not Applicable

Move-in Date

Move-Out Date (best estimate is okay)

Do you need a parking spot at the apartment complex?

Yes

Please select your roommate preference

Male

Female

Co-Ed Apartment OptionThis would only be implemented if we happened to not have enough beds for all interns who wanted to stay in male only or female only housing.

I am willing to live in a co-ed apartment, if it became necessary to accommodate all interns

I am not willing to live in a co-ed apartment

IOGP Internship Information Form