UH CO-OP Application

Thank you for your interest in the UH Cooperative Education Program. Before completing this form, make sure you’ve reviewed all program requirements as outlined throughout our UH Cooperative Education website.

Submission of this form is only one component of the CO-OP application process.

Please read the form in its entirety and complete your answers accurately to prevent a delay in your application process.

CO-OP STUDENT INFORMATION

First Name

Last Name

Student ID Number

Major

Classification (Certificate programs MUST be approved by your department.)

College

Example: Cullen College of Engineering

This is my

Expected Graduation

Format: (Dec, May or Sum/Year)

Academic Advisor

Work Status

If not U.S. Citizen, list native country

U.S. Mailing Address

City

State

ZIP/Postal Code

Phone #

Have You Participated in CO-OP Before?

If Yes, Last Semester and Year

Format: (Fall, Spring or Summer/Year)

Will you have completed at least 2 college/university semesters in the United States by the start of your internship?

Will you need a formal letter from our office to verify you are enrolled in UH CO-OP?

UH Cougarnet Email Address (CO-OP correspondence will ONLY be sent to your Cougarnet email address)

E-Mail Address ending with "@cougarnet.uh.edu"

Confirm email

CO-OP EMPLOYMENT INFORMATION

CO-OP Semester/Year

Format: (Spring, Summer, Fall or Break/Year)

Expected Start Date of Internship

Expected Start Date of Internship: Year

Expected Start Date of Internship: Month

Expected Start Date of Internship: Day

NOTE: THE "END DATE" OF EACH CO-OP "IS THE LAST DAY" OF UH CLASSES EACH SEMESTER. IF YOUR EMPLOYER REQUIRES YOU TO WORK AFTER THAT DATE, YOU'LL NEED PERMISSION FROM ISSS IF YOU ARE AN F1 STUDENT.

Employment Type

Company Name

Company Work Location

City

State

ZIP/Postal Code

Company Phone

Supervisor Name and Title

How did you obtain this job?

This work experience is

Pay rate

/hr

CO-CP Certification

I certify that the above information is accurate to the best of my knowledge. I also agree to abide by the CO-OP guidelines/policies as per the agreement form and authorize the release of my educational records.

STUDENT AGREEMENT

1. By accepting employment, applying to the University of Houston Cooperative Education Program(CO-OP), and initialing each box below, the student agrees for each semester of CO-OP internship to adhere to the following:

Notify the CO-OP Office of the internship so that records can be accurately maintained.
Register for the UH CO-OP course to appear on the official UH transcript through PeopleSoft before starting work. UH CO-OP sections and course numbers are provided by the UH CO-OP team during the application process.
Pay the non-refundable UH CO-OP processing fee each semester. The non-refundable CO-OP fee is $215 and is posted to the student’s PeopleSoft account. Questions regarding fee payment options and deadlines should be directed to the University Business Office.
Submit the required Work Report before the end of each semester. Each semester’s Work Report is posted only in the Blackboard course along with the submission deadline and instructions. The CO-OP grade (Satisfactory or Unsatisfactory) is based upon appropriate completion of the internship and the submission of the ENTIRE Work Report. Any Work Report that does not follow ALL directions provided in the Blackboard course or received past the due date will result in an Unsatisfactory grade on the transcript. UH CO-OP is not for course credit and does not calculate into your GPA.

Note: A grade of Incomplete (“I”) is not offered for CO-OP. Unreported grades (NR) can prevent academic standing from calculating (for example: result in holds being placed on the student account; delay graduation certification; affect financial aid eligibility or athletic eligibility; and result in other negative consequences for students which may not be petitioned to change after the semester has ended), therefore, the only grades posted are “S” and “U” grades. No exceptions.

2.Occasionally employers refer to CO-OP internships using other terms, such as internship, student trainee, orsummer hire. As long as the student is processed through the CO-OP Office, the educational training is directlyrelated to the student’s major and a CO-OP grade is recorded on the official transcript, the student is considered aCO-OP intern with the employer regardless of title or terminology used.

Academic Honesty Statement, Course Policies, & Email/Agreement

Confirm the following statements are true.

Academic Honesty Statement

I understand I am required to read the University of Houston Academic Honesty Policy contained in the UH Student handbook and agree to abide by its provisions. I understand that the instructors associated with CO-OP takes academic honesty very seriously and, in the cases of violations, penalties may include suspension from the University of Houston.

Course Syllabus

I understand I am required to read and therefore understand the CO-OP Course Syllabus document.

UH E-mail Alias Agreement

I understand I am required to read the University of Houston Information Technology website discussing UH e-mail aliases and I understand how to use this alias to receive e-mail through my outside provider.

I understand that it is my personal responsibility to configure this alias properly to receive emails from the university.

I understand that the Cooperative Education Program will use this e-mail alias for all official correspondence.

Submit this form ONLINE

I have read and understand the information in this UH CO-OP Application agreement and agree to abide by all UH CO-OP guidelines. If in the event my CO-OP changes in any way or is cancelled for any reason (this can include CPT, I-20, remote work, or F1 status), I will notify the professor immediately in writing via my Blackboard UH email only. If I am not in the UH CO-OP course and unable to email through Blackboard, I will notify the CO-OP Office directly at ecareers@central.uh.edu to ensure any updates, changes and/or exceptions are documented in my UH CO-OP intern records.

Signature of Applicant

Sign above

Date

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