Rev. 5/22/2015

SPECIAL STUDY INTERNSHIP FORM

See the Academic Section of the UCEAP Guide to Study Abroad for additional information.

Instructions for completing the Internship form

Forms must be submitted to the Study Center or the Systemwide UCEAP Office as soon as possible after the internship has been arranged, and no later than the deadline for students to submit their MyEAP study lists.

All form fields must be completed.

Enter your name as it appears in MyEAP (no nicknames).

The subject area of internship is the subject area that will be on your UC transcript. This may be changed by UCEAP to conform to UC standards. If a change is made, you will be informed before the study list is finalized.

Hours per week by student is the time you will spend performing internship duties.

UC quarter units requested are calculated using direct contact time, indirect contact time, and work submitted. See the Study Center for assistance. Units may be changed at the systemwide office.

Description must be entered on the form. Write a summary statement of the internship including the requirements that must be met to receive a Passing grade.

Attach a full description of internship that includes:

1. Full name and description of the organization. Include links to organization’s websites if available.2. Work schedule. Include work begin date, end date, and weekly work schedule.3. Responsibilities (tasks) in complete detail.4. Outline of steps to implement the internship.5. How the internship work is linked to the field of study.6. Goals and expected outcomes for the student.7. Work that will be submitted for final evaluation.

To Be Completed with your Internship Supervisor

The sections on Supervision and Evaluation should be completed with the internship supervisor. Scheduled Consultation Time should indicate the number of hours per term of direct consultation with the supervisor in discussing the subject of the internship. These hours should not include time spent by the student noted on the top of the form. This would be hours spent discussing what the student is learning and how the experience relates to the broader context of the field. Time spent receiving directions and/or explanations of tasks would not be included.

Written work is required to earn academic credit. The Evaluation section must clearly state the assignment that will be submitted and the date it is due. Assignments may include internship notebooks, research papers, web sites, etc. If submitting a report, the number of pages must be indicated.

The form must be signed and dated by the student, supervisor, and Study Center representative before the Special Study will be entered on the MyEAP study list.

Rev. 5/22/2015

UNIVERSITY OF CALIFORNIA EDUCATION ABROAD PROGRAM

SPECIAL STUDY INTERNSHIP FORM

Name: Year/Term:

Country/Host University: UC quarter units requested:

Home UC campus: Hours per week by student:

Major: Number of weeks of work:

Subject area of project: Work start date: end date:

DESCRIPTION: Supply summary and attach a full project description.

SUPERVISION:

Name of organization:

Supervisor’s name:

Title:

Scheduled consultation time: (hours per week and number of weeks)

E-mail address:

EVALUATION: Work to be submitted for grade:

(e.g., final paper, final project, research paper, etc.)

Final project and supervisor evaluation will be submitted to: (Study Center Director, UC Visiting Professor, or UCEAP Academic Dean)

Work is to be completed by this date: (date must be within term)

I waive my right to see the UCEAP Internship Evaluation form submitted by my supervisor at the completion of my internship. No Yes

Even if you waive the right to see your final evaluation, you are expected to meet with your supervisor on a regular basis for consultation and assessment.

Student's Signature Date Supervisor's Signature Date

Study Center Representative’s Signature Date

SAMPLE

Roger Rabbit

Special Study Project Proposal

Thailand, Fall 2015

Organization: Sustainable Development Foundation (SDF)

Commitment: August 24-December 4, 2015 (8-10 hours/week)

Subject/Objective: Environmental Studies/Sustainability – Watershed management in

Sirindhorn International Environmental Park (SIEP) in Cha-Am (Petchaburi Province)

Description The Sustainable Development Foundation (SDF) emphasizes on building local capacities to meet the development challenges of the next era. Its belief is to help communities in search of

sustainable solutions for their issues. Nonprofit that deals with problems such as climate change,

natural resource management, disaster risk reduction, livelihood diversification, human rights for

rural communities, and the process of sustainable development in various locations in Thailand.

Websites:

http://www.sdfthai.org/

https://www.facebook.com/sdfthai/info?tab=page_info

Responsibilities The student will use resource mapping as a form of data collection. This information will include resources available, the users, socio-economic data, water distribution, prone and risks data, and

climate history. The student will also perform interviews with the Thai people residing in the

affected region to obtain firsthand accounts of the issue. Focus groups and multi-stakeholder

consultations are two additional forms of information collection that will be implemented. In

addition, the student will be trained in GIS software and will utilize GIS mapping throughout the

research. Lastly, the student will conduct a short case study based on their interests and

experience.

Implementation

1. Initial Visit- Forum on Watershed Management in Cha Am 2. Briefing on research design

3. Training on GIS

4. Field Research Trip 1

5. Field Research Trip 2

6. Encoding/Writing

Field of Study: Urban Planning and Development The practice of urban planning is not limited to urban areas, but also includes planning rural and developing communities. Since much of Thailand is still a developing country, planning for

sustainable communities that coexist with healthy environments is an important part of

anticipating urbanization in rural areas. Many ethnic minority groups in and around Cha Am are

experiencing a lack of agricultural resources, while Cha Am’s environment is being used in an

unsustainable manner due to a lack of proper planning processes.

SAMPLE

Goals/Expected Results

To develop knowledge about watershed management in the context of climate change,

with SIEP Sirindhorn International Environmental Park in Cha Am as the case study site

and two sub-watershed areas in Petchaburi as the main study area.

To identify critical problems and issues within the Petchaburi Watershed Area and

explore the socioeconomic effects of these issues for multiple stakeholders.

To examine the irrigation systems used in the area, both by villagers and by resorts, and

analyzing water use patterns.

Investigating the effects of irrigation changes and reservoir changes to the local

agricultural lifestyle.

Through investigative interviews and open dialogue forums, the intern will discover the main

issues underlying watershed management in the region. By utilizing GIS data and resource

mapping the region will be thoroughly documented for the first time. With multiple forms of

data, SDF hopes to gain a better understanding of the area to ultimately help the local people

improve watershed management to better suit their needs.

Final Evaluation The final evaluation for the internship will include the GIS resource maps, self-designed case study, and SDF’s final report on the Cha Am area.

SAMPLE