For Students & Alumni Upcoming EventsCareer ExplorationUniversity Career Services Internship ApplicationCooperative EducationHelpful ResourcesJCPenney Trojan Suit Up EventTrojan Career ClosetRequest for a PresentationVirtual FairsApply for Optional Practical Training (OPT) For Employers Handshake for EmployersUpcoming EventsRequest On-Campus RecruitingEmployer Industry InsightsTrojan Suit Up Event For Staff and Faculty For Staff and FacultyRequest for a Presentation Co-op Position Request Form Name(Required) First Last Trojan ID Number (T#)(Required)UA Little Rock Email(Required) Phone(Required)Did you read about The Co-op Process and understand what you read?(Required) Yes No If you did not read about The Co-op Process, please do so immediately. If you read about The Co-op Process and did not understand what you read, contact us at [email protected] for clarification and/or more information.Have you registered for a Co-Op course when registering for classes this semester?(Required) Yes No Note: You must enroll in Co-Op course upon registering for classes for the semester. The course catalog can be found by clicking on the link. https://catalog.ualr.edu/content.php?catoid=20&navoid=2424Co-Op Course Number(Required)Co-Op Advisor Name(Required)Input the name of the instructor who will instruct the Co-Op class. Co-Op Advisor Phone Number(Required)Major(Required)Minor(Required)If you have not declared a minor, type “N/A”.Have you notified your work supervisor that you want to earn academic credit for your internship or job?(Required) Yes No IMPORTANT: Before submitting your form, you must notify your work supervisor that you want to earn academic credit for your work.Company Name(Required)Work Supervisor's Name(Required)Work Supervisor's Work Email(Required) Work Supervisor's Phone NumberJob Beginning/End DatesCompany WebsiteWhat is your job title?(Required)What are your job duties?(Required)If you would prefer to attach your duties, type “See Below” and upload your information.If you would prefer to attach your job duties, upload the attachment(s) here. Drop files here or Select files Accepted file types: docx, doc, pdf, Max. file size: 24 MB, Max. files: 5. Upload Word or pdf documents only.How many hours per week do you work?(Required)What is your hourly rate of pay?(Required)If approved, I agree to regularly check my UA Little Rock email for important updates regarding the Co-Op process from my faculty advisor, Co-op Coordinator and others involved in my Co-Op(Required) I understand and will regularly check my UA Little Rock email for important updates Captcha For issues with submitting the form, contact us at [email protected].
