Download Food and Nutrition Internship/Independent Study

1
Food and Nutrition Internship/Independent Study Application Form
Directions: Please complete the following application form, and submit it with a printed copy of your Degreeworks
transcript to your faculty adviser. Due dates are: summer and fall semester is during spring advising period and
spring semester is during fall advising.
Resume: You must submit a professional resume with the internship application. Visit the Career Services website
for help with your resume: https://www.framingham.edu/the-fsu-difference/career-services/index Schedule an
appointment with Career Services to review your resume BEFORE you submit it; you must include documentation
that Career Services has reviewed your resume. Once your internship application is approved, send an electronic
copy of your resume to the course instructor.
1.
Student name
2.
Current address
__________________________________________
Date _______________
____________________________
Email address _______________________________________________Phone__________________
3.
Transportation is the student responsibility. Where will you be living during your internship?
_______________________________________________________________
4.
Faculty adviser ________________________
5.
Please check your concentration in the food and nutrition major:
___ FNW (Nutrition and Wellness) ___ FND (Nutrition and Dietetics)
6.
Semester internship requested: Fall 20____
Spring 20____
7.
Expected graduation date, please complete: May 20____
8.
Current QPA for all courses in major__________
Summer 20 ____
August 20____
December 20____
9.
Check the type of internship which you are requesting. Please review course descriptions in the catalog at
https://www.framingham.edu/Assets/uploads/academics/catalogs/_documents/undergraduate-catalogs/20152016-undergraduate-catalog/undergraduate-catalog-2015-2016.pdf
___ NUTR 495 Internship in Food and Nutrition
___ NUTR 499 Food and Nutrition Internship: Natick Soldier Research, Development and
Engineering Center (NSRDEC)
___ NUTR 490 Independent Study in Food and Nutrition
10.
Are you able to communicate in a language other than English?
____ Yes
11.
____ No
If yes, which language? ____________________________________
Are you a certified personal trainer? ____________
If yes, please attach copy of certificate.
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12. Complete the chart below. Write the grade you received for each of the following required courses in major.
Indicate the status courses by writing ‘IP’ to indicate ‘in-progress’; “fall or spring” for all courses to be taken
during proposed internship. Write “NA” for all courses not required in your concentration within the major.
Course
Grade or Status:
see details above
NUTR
NUTR
NUTR
NUTR
NUTR
NUTR
NUTR
NUTR
NUTR
NUTR
NUTR
NUTR
NUTR
NUTR
NUTR
205
262
271
364
374
381
384
333
390
478
479
482
483
490
495
BIOL 142
BIOL 235
BIOL 307
CHEM 103
CHEM 107
CHEM 108
CHEM 201
CHEM 207
CHEM 301
CONS 105
CONS 210
CONS 310
ENGL 286
Nutrition Science and Applications
Food, Culture and Society
Nutrition for Sport and Exercise
Experimental Foods
Human Nutrition Science
Introduction to Nutritional Practice
Foodservice Systems
Chronic Disease
Special topics: “Topic”
Community Nutrition
Computer Applications in Nutrition
Management of Food and Nutrition Services
Medical Nutrition Therapy
Independent Study in Food and Nutrition
Internship in Food and Nutrition (second internship)
Intro. To Human Biology
Human Anatomy and Physiology I
Principles of Microbiology
General Chemistry
Principles of Chemistry
Principles of Chemistry and Quantitative Analysis
Organic Chemistry
Organic Chemistry I
Biochemistry
Personal and Community Health
Consumer Economics
Drug Addiction
Professional Writing
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13. Using the chart below rate the population groups with which you would most like to work and the settings in
which you would like to work. Indicate your first, second, and third choices for both population groups and
settings by placing 1, 2, or 3 in each ranking column.
Populations
General population
Adults
Ranking 1-3
Pregnant or lactating women
Adolescents
School age children
Infants and young children
Geriatric population
Rehabilitation program
Social networking
Other, please specify
14.
Ranking 1-3
In the chart below place an X in front of the skills you would like to develop or improve.
Client / patient counseling
Clinical nutrition (completed MNT)
Staff or professional training
Event planning
Educational program development
Nutrition education
Other, please specify
15.
Setting
Hospital or HMO outpatient service
Hospital or inpatient services
(completed MNT)
Elder nutrition program
Extended care facility
WIC
Child care agency
Cooperative Extension Services
Business or industry foodservice
School nutrition service
Food company
John Stalker Institute
Fitness facility ( PT certificate required)
Farms
Catering
Other, please specify
Speaking to groups
Management skills
Food service operation
Food research and development
Social media
Writing
List your major strengths:
1.
2.
3.
NUTR 495 Internship in Food and Nutrition & NUTR 499 Internship in Food and Nutrition NSRDEC (Natick Labs)
have required steps for the internship placement process, read Overview for NUTR 495 & 499 in the Food and
Nutrition Handbook.
16.
Please provide any additional information which might be helpful in placing you.