Student:______________________________________________________________________

Faculty Advisor:____________________________________________________

Date:__________________________________________

The Student named above has agreed to pursue an internship with an organization outside the University of Maryland Department of Theatre. The Student will receive credit for the Internship pursuant to the following conditions:

Name of Organization:_________________________________________________________________________

Internship Supervisor:_______________________________________________________

Phone Number:___________________________________

Duties:___________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________

Hours:__________________________________________

Start Date:_______________________________________

Completion Date:__________________________________

Departmental Requirements: (journals, paper, report, project, presentation, etc.)

_________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________

Grading Method (Reg/P-F):___________________________

Faculty Sponsor Section Number:_____________________

Credits:___________________________________________

Semester:_________________________________________

Final Project Due: __________________________________

By signing this agreement, the student agrees to abide by the conditions set forth above.

___________________________________________________________________

(Student Signature)

___________________________________________________________________

(Faculty Sponsor Signature)