International Internship Questionnaire for Worldwide Internship Program Application Please Type Name: Student ID: Major/Field of Study:

College/School: Email: Phone: Internship site (Employer/Host): City & Country: Supervisor Name: Supervisor E-mail: Supervisor Phone/Skype:

1. How did you find your internship? Where did you hear about the Worldwide Internship Program?

2. What type of work or research will you be doing? Attach a job description and appointment letter if available.

3. How does this work relate to your major/field of study? Please describe your learning goals for this internship experience.

4. Please summarize the conversation you had with your academic advisor about your internship plans and how this credit fits into your degree requirements. If you have not talked with your advisor, please do so as soon as possible.

Advisor Name: Advisor E-mail:

5. How does the internship involve you in work you would consider as a future career?

6. Please provide the name and contact information for your 24/7 emergency contact in the country where you will be interning. This could be your supervisor, an HR person or a coordinator with an internship provider company, for example. Contact Name: Title: Phone (include country code): E-mail: NOTE: IAP needs an email from your emergency contact verifying that s/he will act in this role and discuss any emergency procedures. Your Study Abroad Advisor will contact your supervisor to confirm this via e-mail. If your emergency contact does not have access to email, please let him/her know IAP will be calling to verify this information and you should provide us with the phone number to call.

7. How many hours per week will you be interning? Most interns work 30-40 hours per week unless they are engaged in more academic coursework than the required 3-credit online internship course.

8. What are the planned dates of the internship?

9. Into which city will you be flying? You will need to submit your final itinerary 8 weeks prior to departure.

10. Please describe the transportation method you plan to use to get to and from your internship site.

11. If you have a schedule of activities that you will be doing, please provide that here or attach a copy.

12. Is this a paid or unpaid internship?

13. Excluding the WIP fee, what are your anticipated additional expenses for your time abroad? This is important for your own budgeting and we will use this information to determine cost of participation which is reported to financial aid for aid package consideration. a. b. c. d. e. f. Airfare: Meals: Books & Supplies: $50 for WIP books Housing: Local Transportation: Personal/Miscellaneous:

14. How do you plan to fund your internship (including savings, financial aid, scholarships, fundraising, etc.)?

15. Do you need a visa to do this type of work/internship in this country? You need to determine this and get any necessary documentation from us and the host as soon as possible to begin the application.

16. Does your employer agree to complete an evaluation at the conclusion of your internship? This is expected of all internship supervisors; the evaluation will be provided to them via e-mail by the International Internship Program (IIP).

17. Where do you plan to live? You will need to provide us with the address 6 weeks prior to departure. IAP will ask you to submit in country contact information shortly after you arrive to your internship site.

18. For the Worldwide Internship Program, you take a 3-credit on-line course to reflect on the internship and engage in reading and discussion of cross-cultural issues in the global workplace. Credit is granted for the academic work and reflection done focused on your internship, but not your internship itself. In addition, you also have the option of independently arranging a directed study with a faculty member at UW-Madison. If you are planning to engage in directed study while you are overseas, please indicate the course title (Department, Number) and faculty member here and submit a directed study form to IAP.

(Optional) Directed Study course: Directed Study Faculty Advisor:

Please review this website to check if your destination has a current U.S. State Department Warning: http://travel.state.gov/travel/cis_pa_tw/tw/tw_1764.html If so, IAP requires students to review and sign an additional safety waiver for programs in a travel warning country. We will review this with you in person if it applies. Note: All programs going to a country with a travel warning need to have final approval by the University International Travel Committee (UITC). IAP will submit your program proposal to the UITC on your behalf. Final acceptance by IAP will be done after this approval from the UITC has been granted.

Thank you! IIP will be in touch with you soon to set up an appointment to discuss your internship plans.