HMSV 468 Request for Reduction - 100 Indirect Hours

This form represents a request for up to 100 indirect hours reduction, to be applied to the Human Services 468 Internship course. Submission of this form does not guarantee approval.

The request must be approved before the beginning of the internship semester and addressed with your site supervisor.

Name Name * First Last
UIN *
University Email *
Internship Semester *
Please fill in below the specific details of your previous experience and how that experience is applicable toward your current enrollment. A maximum of 100 indirect hours may be reduced; this approval is subject to evaluation by the program coordinator. This is not a direct transfer of hours, yet a reduction up to a maximum of 100 indirect hours.
REASON FOR REQUEST: please select one: *

REASON FOR REQUEST: please select one: Associate's degree in related field that included an internship course Previous paid work experience All applicants who do NOT have an associate’s degree in a related field must have at least two years of paid experience in a human service agency to be considered for a possible reduction in internship hours.
If you selected Associates Degree in related field that included and internship course, please attach the following:

If you selected Associates Degree in related field that included and internship course, please attach the following: a copy of an official transcript showing the awarded degree with the internship course
If you selected previous paid work experience, please attach EACH of these:

If you selected previous paid work experience, please attach EACH of these: A cover letter explaining your request. An expanded resume detailing your work history, duties, etc. Documentation in the form of a letter from your former supervisor on agency letterhead. An official job description. A learning essay detailing your experiences, activities, and what you have learned through them. This essay should be typed, double-spaced, and at least 300 words
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By signing below, I am requesting that up to 100 indirect hours be reduced from the required 400 hours of HMSV 468 Internship, during the semester and year indicated above. I understand that submission of this form does not guarantee approval and the internship coordinator will contact me with the decision regarding my application.
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