University of Maryland, College Park

Federal Fellowsand

Global Fellows in Washington, D.C.

2017-2018 Federal/GlobalFellows Internship Award Acceptance Form

Circle: I acceptORdo not accept the $500 internship award for the Spring 2018 semester.

I understand that in accepting this award, I am expected:

  • To be enrolled in and complete all requirements for FGSM398 (or an equivalent internship course) in Spring Semester of 2018.
  • To complete and submit the Internship SiteContract by February 9, 2018.
  • To participate in (and complete) all required Federal/GlobalFellows Program requirements (e.g., Final reception with poster/flier, three required events over the course of a year, final intern evaluation from supervisor, concluding internship program report, etc.).
  • Please confirm your 2 approved supplementary courses: 1. ______2. ______
  • To keep the Federal/Global Fellows Program updated after graduation with future career, internship, volunteer activities, etc. (We treasure you all as future alumni and promise on our part to continue to support you the best we can!)

Course: FGSM 398 or Other Course ______(Please specify)

The $500internship award will be distributed as soon as possible.

Circle your program participation: I am a participant of the Federal Fellows OR Global Fellows program.

Full Name (please type or print): ___ UID#: ______

College(s) & Major(s): ______

Internship Site/Organization Name: ______

______

Student Signature: Date: ______

By signing this form, you authorize the University of Maryland to credit the award amount directly into your student account. Important note:If you have any outstanding commitment to the University, when the award is processed and credited into your account, it will be automatically applied to pay your outstanding balance.

If you have special circumstances e.g. scholarship that precludes you from receiving additional awards, to explore different payment options please talk to Jay Arasan, Assistant Director.

Please scan and upload this formto the Federal and Global Fellows’ Online Portal by February 9, 2018. Any late submissions after the deadline may NOTbe accepted and will disqualify you from funding eligibility.