Hrtm 495 - University Of South Carolina Internship Information Form

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School of HRTM
HRTM 495 Internship
Information Form
Semester:_______________
Major: ______
_______
Hospitality
Tourism
___________________________________________________________________________________________________
Student's ID #
_________________
Student's Name
___________________________________________
______
Student's Address
City
State
____________________________________
____________________
____________________________________
_______________________
Student's Phone #
Student's Email
Area Code
Number
Extension
Name of Organization
_____________________________________________________________________
Organization Address
______________________________ City ______________________ State ______
__________________________________
Business Phone
Extention
Area Code
Number
_________________________________________________________________________
Supervisor's Name
Supervisor's Email
_________________________________________________________________________
Intern's Job Title
__________________________________________________________________________
_________________________________
_________________________________
End Date
Start Date
Days of the week Intern is expected to normally work
_____________
_______
_______
Are you compensated for this internship/practicum experience?
Yes
No
_____________________________________________________
If you are paid a wage, what is the hourly rate?
If you are not paid a wage, but are compensated with a stipend, commission, housing, food or other forms of
compensation, please explain:
_________________________________________________________________
Does this Internship count toward: Club Management Specialization ______ , Meeting & Events Focus ______
Total Hours per Week:
____________
Give a thorough description of the internship duties and responsibilities in the space below. Attach an additional sheet if necessary.
_______________________________________________________________________________________
_______________________________________________________________________________________
I, the student, understand that I am required to work 400 hours before the end date above.
_____________________________________________
Student's Signature
Date
_______________________
I, the supervisor, understand the student must have the opportunity to work 400 hours before the end date above.
___________________________________________
Supervisor's Signature
Date
_______________________
_____________________________________
_______________________
Faculty Instructor's Signature
Date
ANY JOB-RELATED CHANGES MUST BE REPORTED IMMEDIATELY
* Complete, sign and attach Supervisor's Business Card & Photo of Yourself *
Submit to Glenna Gillentine
________________________________________
ggillentine@hrsm.sc.edu / P 803-777-2685 / F 803-777-1224
University of South Carolina
701 Assembly Street
Columbia, South Carolina 29208

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