Name:  

Mailing address where applicant may be reached during application period:

Street                                                                  City                            State          Zip Code  

If temporary, add permanent address.

Street                                                                  City                            State          Zip Code  

Telephone numbers where applicant may be reached during application period:

         Current:       ___________________________

         Permanent:  ___________________________  

Email address:  

Current status of applicant (check one):

q Undergraduate    q Graduate   q Other --specify: _____________________

Is applicant a member of a U.S. federally recognized tribe?

q Yes       Tribal affiliation(s): ________________________          q No

Is applicant is a US citizen? q Yes   q No

Check which one of the upcoming internships for which you wish to apply:      
Student Honors part-time internship (if available):     q Fall 2007

Professional (post-graduate) internship in archives:  q October 2007 - June 2008

You may propose alternate dates, but preference may be given to applicants available for the above dates.  If requesting alternative dates, please indicate requested dates: 

Please indicate the area(s) of the center in which you wish to intern in order of preference.  Applicant may apply to one or both of the following:  Archives, Library.

1.
 

2.

Does the applicant read, write and speak English fluently? (check all that apply).
q Read        q Write       q Speak

Does the applicant read, write and speak a language other than English fluently?  (check all that apply)

    Other language(s):   1.______________________  q Speak   q Read/write

                            2. ______________________  q Speak   q Read/write

                            3._______________________ q Speak   q Read/write

If currently a student:

Current academic year:__________       Major:_______________________

Institution:____________________       Cumulative GPA: _____________

List all institutions attended, and degrees and dates awarded:

Transcripts required:  Please send copies of academic transcripts from current or last institution attended to the Center.  If transcripts will be sent directly from academic institution, please complete:
        ______________________________          ___________________________

           Institution name                                              Date applicant requested transcript

References required: Names, addresses, phone and email of at least two persons who are sending references, or include at least two reference letters and phone numbers with application. 
If you are currently employed in the internship area that you are applying to, one reference should be from present employer.

CIB required:  Please submit with your application either your Certificate of Indian Blood (CIB) or a copy of your tribal membership card.

How did you learn about the Center’s Native American Internship Program?

Is applicant covered by health insurance?         q Yes       q No

Name of insurance company and policy number:

Acknowledgment required:  Applicant's signature and date:
_________________________________                 _____________________________

                 Signature                                                                             Date

Applicants who plan to receive academic credit for internship(s) must complete and attach the following form to the application

The Center of Southwest Studies at Fort Lewis College accepts interns, qualified students or graduates from academic institutions in the United States and abroad.

In many cases students receive academic credit for these internships.  In some cases students pay full or substantially full tuition to their universities in order to obtain credit for instruction conducted at the Center.  If you are applying for an internship and expect academic credit from another institution, you must make the necessary arrangements through that institution.  The Center encourages colleges and universities to waive tuition for students on internships at the Center.

If you are applying for the Professional Internship, please check one of the following:

q     I will be receiving college/university credit for this internship from another institution.

q     I am a current Fort Lewis College student and will continue my enrollment during the internship period.

q     I am not currently a Fort Lewis College student but I would like to receive credit through Fort Lewis College.

If you are applying for the part-time Honors student internship, please check one of the following: 

q     I will be receiving college/university credit for this internship from another institution.

q     I am a current Fort Lewis College student and will continue my enrollment during the internship period.

q     I am not currently a Fort Lewis College student, but I would like to receive credit through Fort Lewis College.

Fort Lewis College credit hours you would like to earn with this internship:

 
(it is possible to earn from one to nine credit hours per semester):              ________________
 

Note: student participation of 45 hours per credit hour is required. 

Native American Internship Honors Program Application:
Required Attachments

  Please attach each of the following items along with your application:
 

A.     Certificate of Indian Blood (CIB) or tribal enrollment card. No applications will be accepted or reviewed without this attachment.  Exception: not required if you are currently a Fort Lewis College student. 

B.      Essay.  Prepare an essay (typed, in English) and attach to this application form.  The essay should discuss why you are seeking an internship, especially as related to your academic or professional development and goals.  Indicate the types or areas of work in which you wish to participate and/or experience and explain why an internship at the Center is particularly well suited to your needs.  The essay should be between 500 and 1,000 words in length. 

C.     A brief description of related work experiences. 

D.     A list of special skills and/or interests such as office, computer, public speaking, cultural knowledge and artistic abilities that you can bring to an internship. 

E.      Current resume