Internship in Social Responsibility and Impact in Business Prescreening Form

Thank you for your interest in enrolling in a Marketing Department internship course. This pre-screening form is used to verify your eligibility and ensure that your internship experience meets the academic requirements for course credit.

Before completing this form, please confirm that you have secured an internship and have completed (or will complete prior to the internship) the prerequisite course, MKTG 5115. Submission of this form does not guarantee approval or enrollment.

Once submitted, your information will be reviewed by the Marketing Department Internship Program Director, William Ryan. If approved, you will receive a authorization via email to enroll in the appropriate internship course. You may be contacted if additional information or clarification is needed during the review process.

Please complete all required fields accurately and thoroughly. We look forward to supporting your internship experience.

Step 1 of 4

Phone

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Student ID Number(Required)

UConn Email(Required)

Enter Email Confirm Email

What is your current campus?(Required)

Major(Required)

In which term will you/did you complete MKTG 5115?(Required)

MKTG 5115 is the pre-requisite to earn academic credit for a MKTG internship.

In which term would you like to take the MKTG 5881 internship course?(Required)

Internship Information

Internship Position Title(Required)

Company Name(Required)

Company Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Website(Required)

Name of Hiring Contact(Required)

First Last

Email of Hiring Contact(Required)

Phone of Hiring Contact(Required)

Internship in Social Responsibility and Impact in Business Prescreening Form

Internship Information

Please provide additional information to help us understand the nature of the internship.