MIIC Intern Hire Verification

This form should be completed by internship candidates after their employer has been approved for the Maryland Institute for Innovative Computing.

Agency/Department's MIIC application number

(Provided to your employer when they applied for funding.)

Semester

Semester/Term you are verifying to be funded by MIIC

Year

2025

Participated in MIIC before?

Have you previously participated in an MIIC funded internship with this company/organization? If yes, how many semesters?

First Name

Last Name

Personal email address

If you are not a UMBC student, please do not provide your college "edu" email. Please provide a gmail, yahoo, hotmail, comcast, me.com, etc. email so as not to conflict with any existing or future Handshake account at your current college.

Re-enter Email Address

Linkedin Profile URL

Cell/Primary Phone number

Permanent Address 1

{name}

Address 2

{name}

City

State

Zip code

Race

Gender

The following describes me

Select one that applies to you

Current college student attending a Maryland college.
Maryland high school graduate attending a college outside of Maryland.
Graduate (within 12 months) of a Maryland college.
Maryland resident, with a 2 or 4-year degree, who has been honorably discharged from the U.S. Armed Forces, The National Guard or a Reserve component of the Armed Forces within the last 18 months.
The above categories do not apply to me.

Have either of your parents or guardians completed a bachelor's degree?

Will you be requiring CPT approval for this position?

Skip this if not an F-1 Visa holder

Current/Recent University/College

Select "Other" if your university/college is not in the list

Add

Major(s)

Class Level

Graduation Month

Graduation Year

Cumulative Grade Point Average

Action:

In addition to submitting this form, please send your unofficial transcript verifying your GPA to miic@umbc.edu (PDF attachment preferred).

I agree

Agency Name

Select "Other" if the agency is not in the list

Add

Internship Title

Hourly Pay Rate

$/hr

Estimated Hours Per Week

Intern Supervisor First Name

Supervisor Last Name

Supervisor Title

Department

Supervisor Primary work phone number

Supervisor Email address

How did you find your internship?

MTIP Website
Your College's Job Listing Website
Baltimore Collegetown Website
Other Website such as Indeed or LinkedIn
Career Fair/Recruitment Event
Support from your college Career Center
Network: Family, Friend, Faculty Referral
Other

Verification Confirmation

I certify that the above information is correct and will be used to verify my internship employment as a requirement for Maryland Institute for Innovative Computing funding to your employer.

Do not submit passwords through this form. Report malicious form

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