Intern Request Form

Offender’s Name:

Request Information
Open for Recruitment:
Available Positions:
Internship Position Title:
Duration of Internship:
Hours Per Week:
Intern Supervisor:
Phone:
Site Internship Coordinator:
Phone:
What is the education level required for this internship? Undergraduate Graduate Post Graduate
Desired and/or related majors:
Student Information
Complete this section if you have a specific student or college/university in mind to fill the position you are requesting.
Student’s Name:
Phone:
College/University:
Phone:
Internship Information
What is the purpose of this position?
What are the specific duties to be assigned to this position?
What are the minimum qualifications for this position?
This position will be paid unpaid.
If paid, the salary will be:
per hour.
IDOC Approval
Your signature indicates that you have reviewed and agree to process this request.
Manager (or Designee’s) Name
Signature
Date
Site Coordinator’s Name
Signature
Date
HR Coordinator’s Name
Signature
Date
IDAHO DEPARTMENT OF CORRECTION
Grievance and Appeal Form
IDAHO DEPARTMENT OF CORRECTION
Intern Request Form
212.07.01.001
(Last updated 4/7/14)
Appendix B
316.04.01.001
(Appendix last updated TBD)