http://www.naceweb.org/about-us/press/2017/the-key-attributes-employers-seek-on-students-resumes/

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SAMPLE APPLICATION For

PSY 390: APPLIED PSYCHOLOGY INTERNSHIP I

Directions

Applications for PSY 390 should be submitted to Dr. Michael Butler, Director of Applied Psychology

Internships, at least two weeks prior to the first day of your eligibility to register for upcoming classes,

during the semester preceding the semester during which you hope to do an applied psychology

internship. For example, if you are hoping to do an internship during the spring semester, you should

plan to submit this application at least two weeks prior to the first day of your eligibility to register,

during the preceding fall semester.

Please contact Dr. Michael Butler, Director of Applied Psychology Internships, to schedule a meeting to

discuss your application. Please note that electronic permission requests to join PSY 390 will not be

approved in Self Service, unless applicants have previously met with Dr. Butler. Office: Old Main 301,

Phone: 360-438-4355, Email: mbutler@stmartin.edu.

Student Name: _________________________________________

Date: ___________________

Year in School: Junior or Senior (circle one)

NOTE: Junior status is required; Seniors have priority status

Expected Graduation Date: __________________

Please list all of the upper division psychology courses that you have taken (or will have

completed) prior to the start of the semester during which you are hoping to take PSY 390:

____________________________________ __________________________________

____________________________________ __________________________________

____________________________________ __________________________________

____________________________________ __________________________________

The Ethical Principles of Psychologists & Code of Conduct (American Psychological

Association, 2017) requires that psychologists, and the interns who work under them, abstain

from working in the field, when they know, or should know, that there is a substantial likelihood

that their current “personal problems” or “conflicts” could cause risk of harm to those with

whom they work (clients, patients, students, etc).

Are you aware of any current personal problems or conflicts that have the potential to adversely

impact your work in the field: Yes or No (circle one). If you answered “Yes”, please explain:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

To which local community agencies or organizations are you planning to apply, if your

application for PSY 390 is approved?

_____________________________________ __________________________________

_____________________________________ __________________________________

_____________________________________ __________________________________

_____________________________________ __________________________________

_____________________________________ __________________________________

What are your current, post-graduation plans?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Saint Martin’s

University School of

Business Sample

Internship Contract

Interns: Please complete your internship contract with the help of your academic advisor,

internship supervisor (employer), and internship coordinator.

Intern information:

Name: SMU ID:

Current mailing address:

Email address: Phone number:

Academic information:

Internship coordinator: Credit request (1-6):

Course information:

BA 390 (juniors) BA 490 (seniors) ACC 390 (juniors) ACC 490 (seniors)

Internship supervisor information (employer):

Business name:

Supervisor’s name:

Email address: Phone number:

Start date: End date:

Estimated hours/ week: Hourly rate of pay:

Goals and objectives: (Interns should develop at least three specific and measureable goals

with their academic advisor.)

1.

2.

3.

Intern/ job description:

Signatures: (Must be completed in the order they are presented.)

Intern: Date:

Advisor: Date:

Supervisor: Date:

Internship Coordinator: Date:

Dean: Date:

This agreement may be terminated by the intern, the college, or the employer at any time.

International students must discuss their internship opportunity with the

Office of International Programs.

Signature of OIPD Representative: