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.

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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