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zUYPa3ZVUzMuFo6WynuaGRTt6ZeMsRPm53vxDzd8VAinQJYEE3Ef4DdgyIA2zQ3iLWWjjhGWb44wUvEhtsTBpuxpZUuYF

Internship Application & Internship Funding & Travel Request

myHub URBEST Internship Application & Internship Funding & Travel Request

If you will be completing an internship experience, please complete the myHub URBEST Internship Application. In addition, trainees completeing an intership can also make a request for internship and travel funding for your internship experience through myHub. Please not that funds are not guaranteed, but are reviewed as part of the application and will review each funding request. Please provide all details outlined in the internship application. Questions, please email myHub@urmc.rochester.edu.

URID

* must provide value

First Name

* must provide value

Last Name

* must provide value

Email Address

* must provide value

Trainee Type

* must provide value

Master's Program

* must provide value

Are you an MD/PhD?

* must provide value

PhD Program

* must provide value

Year in program

* must provide value

Official SMD Title

* must provide value

Department

* must provide value

IDP Mentor's First Name

* must provide value

IDP Mentor's Last Name

* must provide value

Start Date of Internship Experience (Month/Date/Year)

* must provide value

End Date of Internship (Month/Date/Year)

* must provide value

Organization/Company name where you will be completing the internship experience

Organization/Company City

Organization/Company State

Organization/Company Country

Where will you be completing this internship?

If outside of Rochester, NY; location of internship (City, State, Country)

If partially in-person and remotely, please explain

Have you communicated with your P.I./advisor and program coordinator about your internship experience?

Yes

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Is this a paid internship experience?

Yes

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If a paid internship, what salary will you receive during the experience?

Is the internship experience providing any additional benefits including housing, travel allowance?

Yes

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If yes, what benefits are they providing? Please provide details

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Do you need to travel to participate in this experience?

* must provide value

Do you need assistance with lodging and travel for your internship experience?

Yes

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Amount of support requested with itemized justification. (Please create an itemized budget including item/service to purchase with cost, ex. transportation and lodging costs) (If uploading Excel File, please write Excel file attached in notes box.)

* must provide value

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Budget File

Upload file

At the conclusion of the internship experience, I acknowledge that I will complete the following items....

* complete a myHub URBEST Experiential Learning Blog Post (300 words or less) with photo
* provide a short presentation of the experience and answer questions at an upcoming myHub Career Exploration event
* complete a short evaluation of the Internship program and experience

* must provide value

Yes

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CV (Curriculum Vitae)/Resume

* must provide value

Upload file

Offer Letter/Email from Internship Site

Upload file

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