International Students and Scholars Office415 South Street | Kutz Hall 215 | MS 040 | Waltham, MA 02453-9110 781-736-3480 | 781-736-3484 Fax | isso@brandeis.edu | www.brandeis.edu/isso J
Trang 1International Students and Scholars Office
415 South Street | Kutz Hall 215 | MS 040 | Waltham, MA 02453-9110 781-736-3480 | 781-736-3484 Fax | isso@brandeis.edu | www.brandeis.edu/isso
J-1 Student Intern Program Academic Advisor (Home Institution)
Recommendation Form
To Be Completed by the Student Intern:
Name (Last/Family Name, First, Middle):
I hereby grant permission for the information provided on this form to be forwarded to Brandeis University
Student Intern’s Signature:
To Be Completed by the Academic Advisor at the Student’s Home Institution:
Advisor’s Name (Last/Family Name, First, Middle):
Title:
Advisor’s Email Address:
Name of Institution:
Institution’s Mailing Address:
Student Information
Degree that the student is currently pursuing at your institution:
Student’s estimated degree/certificate completion date at your institution (month/day/year):
By signing this letter, I certify the following:
• This internship will fulfill the educational objectives for the intern’s current degree program at his/her home institution.
• I certify that the student will be earning credit or fulfilling a requirement of their undergraduate degree program
• I approve this student’s participation in their internship at Brandeis University.
Advisor’s Signature: _
Date:
If the student intern served as a translator/interpreter for the advisor, please sign below confirming that the
advisor fully understood the content of this document and the internship opportunity at Brandeis University before signing
Student Intern’s Signature _