Office Hours

Monday-Friday
8:00am-4:30pm

Contact Career Services

Career Services
Eastern Illinois University
1301 Human Services
Charleston, IL 61920
217.581.2412
llmoore@eiu.edu

Externship Program Application

Please complete the application and submit. You will then be contacted by the Externship Coordinator to schedule a meeting to discuss potential sites and times. Questions? Please contact our Externship Coordinator at 217-581-2412.

Name * First Last
EIU E-number *

Number on your Panther Card
Date of Birth / MM / DD YYYY
Local Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Home Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone * - (###) - ### ####
Email *
Major *

If undeclared, enter Undecided in this field.
GPA *
Class Standing * 2nd semester Freshman Sophomore Junior Senior
Grad Year
Job Title or Field Desired. (Based on completion of Career Balance Sheet) Please list in order of preference. *
Locations available to shadow (i.e. Chicago, Charleston): *
Goals for shadowing. Write at least three (3) goals. See samples below. *
SAMPLE GOALS
. Observe and experience activities of the occupation to get a better idea of what a typical day would be like.
. Gain a better understanding of the particular challenges, frustrations and problems of working in this field.
. Learn the personal attributes, skills and talents necessary to be effective in the field.
. Find out the fringe benefits and rewards of working in this profession.
. Discover what earnings and advancement opportunities exist.
. Inquire about occupation's outlook, including current trends/developments, and growth expectations.
. Determine the benefits of pursuing an internship or a volunteer position to better prepare myself for entering the field.
. Determine if graduate school or additional training is recommended/required for entering field.
. Discover what career paths are similar to a career in this profession.
Relevant Coursework:
I understand that Career Services will be accessing my grades as part of the externship placement process. * Yes, I accept these terms
I understand that I am making a COMMITMENT to attend my externship placement. If I do not attend, I MUST notify my externship host and Career Services NO LATER THAN 48 HOURS PRIOR TO MY SCHEDULED EXTERNSHIP TIME. Should I fail to do so, my student account will be billed a $20 cancellation fee. * Yes, I accept these terms.
Participation in the Externship Program is FREE for students who are members of Panther Recruiting. Those students who are not members of Panther Recruiting will be billed the $40 registration fee and automatically given access to Panther Recruiting. More information about your Panther Recruiting account will be sent to your email. * Yes, I accept these terms
I have read all of the Externship requirements. I understand that I am responsible for the following:
1. ) Researching my Sponsor's career field and organization to prepare myself for Externship.
2.) Notifying my Sponsor and Career Services of any changes in my schedule in the event I am unable to attend my Externship.
3.) Completing an evaluation and returning to Career Services by required deadline following Externship.
4.) Submitting reflection/action plan to Career Services by required deadline.
5.) Sending thank you letter to sponsor within 48 hours after Externship.

In addition, I agree to maintain the confidentiality of any sensitive information I may receive from others or obtain on my own observation during Externship regarding patients, business plans, private records and other non-public information. Yes, I accept these terms

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Externship Program Application

Externship Program Application