Master of Public Administration Program Internship/Co-op Approval Form

Name*

First Last

NU ID*

Email*

Are you seeking approval for a co-op or internship? (Please check one.)*

Co-op
Internship

Are you an international student?*

Yes
No

If yes, have you completed the OGS CPT Form?*

Yes
No

If not, please go to www.northeastern.edu/ogs/ and view the Employment link to find the CPT Form.

Internship Agency/Organization Name*

Agency/Organization Mailing Address*

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

Supervisor Name*

Supervisor Email*

Supervisor Phone Number*

Type of Internship*

Not for Academic Credit (0 SH Course)
For Academic Credit (4 SH Course)
Unpaid
Paid

Semester and Year of Internship*

Start Date*

End Date*

Hours Per Week*

Please describe, in two or three sentences, what your agency/organization does and what aspect of that work you would be working on:*

Please describe, in two or three sentences, what you understand that your duties and responsibilities will be while interning at this agency/organization:*

Please describe, in two or three sentences, any major research efforts, projects or tasks that you would be responsible for:*

Master of Public Administration Program Internship/Co-op Approval Form

Master of Public Administration Program Internship Approval Form