Application for the UCI Chemistry Field Studies Program

"Chemistry 197: Independent Study" will provide course credit for students participating in the UCI Chemistry Field Studies Program. Please fill out this form to apply if you would like formal consideration of course credit for an internship at a company that is not currently listed as a partner with the UCI Field Studies Program. If you aquired your internship thorugh enrollment application through this website to one of the listed companies and positions, please direct your inquiry for course credit to the Chemistry Undergraduate Office: undergrad@chem.ps.uci.edu

The information you include in this form will be reviewed by the Chemistry Department. Please be sure to complete each portion accurately and completely. Incomplete applications will not be approved.

Please review steps for enrolling in Chem 197 prior to completing this form.

UCI ID Number *

Name *

Email *

Phone Number *

Your Major *

Quarter of proposed field study *

Year of proposed field study *

i.e. 2012

Placement Information

Placement Site *

Site Address *

Site Phone Number *

Supervisor's name *

Supervisor's email address *

Hours per week *

Number of units requested *

(25 hours of independent study per quarter equals 1 unit of academic credit).

Description of field study site and duties *

How does your independent study further your academic and/or career goals *

I have filled out this form with accurate information *

I have filled out this form with accurate information. I understand that misrepresenting or fabricating my GPA or other qualifications is a violation of the UCI Academic Honesty Policy, and that Academic Honesty is required for participation in the UCI Chemistry Field Studies internship program. I understand and allow that my qualifications and statements, including UCI GPA and transcript, will be checked by UCI and/or the company to which I am applying in order to confirm my eligibility for participation in this University internship program.

Search form

Application for the UCI Chemistry Field Studies Program