ࡱ> 130a bjbjzz 0 P\P\ 2ppppp8$h$` p pp"Rpp{D!80hp0  h> 6: REQUEST FOR EXPERIENTIAL LEARNING PLACEMENT University of Massachusetts Lowell Department of English Name of student requesting placement: _______________________________________ Student UMS#: _____________________________________________________ Mailing Address: _____________________________________________________ _____________________________________________________ Email Address: _____________________________________________________ Telephone: _____________________________________________________ Year in college: ____ freshman ____ sophomore ____ junior ____ senior Major (concentration): ____________________________________________________ Minor (if applicable): ____________________________________________________ What kind of placement are you seeking? ___ volunteer work (informal position, varied hours, no college credit) ___ internship with no academic credit (formal position, usually 100+ hours) ___ internship with practicum credit (formal position, __ 3 credits OR __ 1 credit) When do you wish to begin your placement? ___ Fall ___ January ___ Spring ___ Summer (YEAR ______________ ) How many hours per week are you able to devote to this placement? _____________ Do you have a placement already in mind? ___ No, I do not have a placement in mind, but I would like help finding one that will help me to attain my learning and career goals. ___ Yes, I am interested in the following placement(s), ranked in order of preference: _____________________________________________________________________ _____________________________________________________________________ Please describe your learning and/or career goals, and why you are seeking an experiential learning placement. List the names of three 51Ƶ faculty and/or staff members who can provide a recommendation supporting your application (we will contact them directly--please do not ask them to send us information but do be sure to ask their permission to be listed): 1. Name: Department: Email: Office phone: 2. Name: Department: Email: Office phone: 3. Name: Department: Email: Office phone: NOTE: This is just a preliminary form to express your interest in an experiential learning placement. To earn credit for internships through the Practicum, students must submit a resume and complete a formal application in consultation with a designated faculty member. Please submit this completed form to Prof. Diana Archibald, English dept.     Last updated November 19, 2016--DCA , 0 d  !%&kl'(45<=KLUVbcjkyz h&Y6hk]h:6>*hk]h:6hh:CJ h h:hh:CJ$hJ:h:5hJ:h&Y5 h&Y5hh:5>* hh:hh:6h&Yh:h h:5>*8,efgB C | }   X Y  e f 0]0^gd:0]0gd: $0]0a$gd:f  6 7 %&l 0]0^gd&Y0>]0^`>gd: 0]0`gd:0]0gd: 0]0^gd:'(45<=K0]0gd:KLUVbcjkyz$a$gd&Ygd&Y0]0gd:hNGh&Y6CJaJh&Yh&Y6CJaJh{mjh{mU hPm{6 h&Y6hk]h:6.:p:/ =!"#$% s666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666666866666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p(8HX`~8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA D Default Paragraph FontRiR  Table Normal4 l4a (k (No List 44 &Y0Header  !6/6 &Y0 Header CharCJaJ4 @4 &Y0Footer  !6/!6 &Y0 Footer CharCJaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VvnB`2ǃ,!"E3p#9GQd; H xuv 0F[,F᚜K sO'3w #vfSVbsؠyX p5veuw 1z@ l,i!b I jZ2|9L$Z15xl.(zm${d:\@'23œln$^-@^i?D&|#td!6lġB"&63yy@t!HjpU*yeXry3~{s:FXI O5Y[Y!}S˪.7bd|n]671. tn/w/+[t6}PsںsL. J;̊iN $AI)t2 Lmx:(}\-i*xQCJuWl'QyI@ھ m2DBAR4 w¢naQ`ԲɁ W=0#xBdT/.3-F>bYL%׭˓KK 6HhfPQ=h)GBms]_Ԡ'CZѨys v@c])h7Jهic?FS.NP$ e&\Ӏ+I "'%QÕ@c![paAV.9Hd<ӮHVX*%A{Yr Aբ pxSL9":3U5U NC(p%u@;[d`4)]t#9M4W=P5*f̰lk<_X-C wT%Ժ}B% Y,] A̠&oʰŨ; \lc`|,bUvPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!R%theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]   1114 f K 8@0(  B S  ?k   !*jtGQ   33333:NGPm{{m)&Y @ @UnknownG.[x Times New Roman5Symbol3. .Cx ArialA$BCambria Math 1hMK'MK'w[w[!24  K#qP$P-2!xx ,=Preliminary Application for Internships/Practica/VolunteeringArchibald DianaKatherine Shrieves Oh+'0 8D d p |@Preliminary Application for Internships/Practica/VolunteeringArchibald Diana Normal.dotmKatherine Shrieves2Microsoft Office Word@@>i]D@>i]Dw[ ՜.+,0$ hp|    >Preliminary Application for Internships/Practica/Volunteering Title !"#$%&')*+,-./2Root Entry F{D41TableWordDocument0 SummaryInformation( DocumentSummaryInformation8(CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q