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APPLICATION FOR INTERN POSITION

Name

Address

City/St Zip Code

Home Phone Other Phone

email

Emergency Contact Name Phone Number

Are you a US citizen? Yes No

If not, citizen of Visa Type

SSN ASU ID Birthdate

Have you particpated in another internship program? Yes No

If yes, name of program and dates:

Have you ever been employed at ASU? Yes No

If yes, department and dates:

Your major: Degree sought Graduation Date

Cumulative GPA Major GPA

Eligibility Requirements

CS CSE EE IE CST

NOTE: REQUIRED COURSES ARE DEPENDENT UPON YOUR MAJOR

CS/CSE Courses completed: CSE 421 CSE 360

Yes Yes
Grade Grade

EE Courses completed: EEE498 - Real-Time DSP

Yes Grade
IE Courses completed: IEE 385 IEE 376
Yes Yes
Grade Grade

CST Courses completed: CST 316 OR CST 400

Yes Yes
Grade Grade

CST 420 OR CST 456 OR CST 486

Yes Yes Yes
Grade Grade Grade

Employment

List last three positions, beginning with your current position:

Dates: From: To: Title:

Employer: Supervisor:

Address: Phone Number

Description of Duties:

Dates: From: To: Title:

Employer: Supervisor:

Address: Phone Number

Description of Duties:

Dates: From: To: Title:

Employer: Supervisor:

Address: Phone Number

Description of Duties:
 My overall grade point is:

Yes While participating in the internship program, I will be a full time student and not
employed, either on or off campus.

Complete this application and send by email to embedded.systems@asu.edu.

Please send us a minimum of two letters of reference - one from a non-faculty member.

Send an electronic copy of your resume to embedded.systems@asu.edu.

Attach a Personal Statement (one page) summarizing your level of interest in embedded systems and what you
expect to derive from your embedded systems focus and your career goals.

To the best of my knowledge, the information contained in this application is a true and accurate representation. I
have read, understand and agree to the rules and requirements stated for this program. In addition, I understand
that eligibility to this internship program will be verified through university records.

Please note: The industry partners decide on the candidates to interview and hire - the Consortium screens the applications
and resumes for complete and accurate information and then sends the information to the partners. You will be notified if
they wish to interview you.

There is a limit of three (3) semesters for this intern program.

You must be able to commit to work the following hours:

Spring and Fall semesters Summer
340 440

You will be paid through the ASU payroll system.

Your presence will be required all day at the Internship Presentation.

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