Bioengineering Industrial Internship Program    University of California, San Diego
9500 Gilman Drive, 0412  u La Jolla, CA 92093-0412  u PHONE: (619)822-1010  u FAX: (619)534-5722
1)Complete the form on your screen  2)Print   3)Fax or mail to our office. Student Application: ABET Bioengineering (By completing this form you agree to submit a 1-2 page report upon the completion of the first 10 weeks of your internship.)
Applicants Name:
Address:
City:
State:	Zip:
Telephone:
E-mail address
Check the Lower Division courses you have completed:
AMES 10 FORTRAN for Engineers	AMES 154 Numerical Methods in Engineering
BE 100 Intro. to Bioengineering Design	Chem 131 Physical Chemistry
BILD 1 The Cell	Phys 2CL Fluids, Waves, Thermodynamics, and Optics Lab
CHEM. 6A General Chemistry	CHEM. 6B General Chemistry
CHEM 6BL General Chemistry Lab	AMES 105 Intro to Mathematical Physics
AMES 158 Computer-Aided Analysis & Design	Math 20A Calculus for Science and Eng.
Math 20B Calculus for Science and Eng.	Math 20E Vector Calculus
Math 20F Linear Algebra	Math 21C Calculus and Analytic Geometry
Math 21D Introduction to Differential Equations	Phys. 2A Physics-Mechanics
Phys. 2B Physics-Electricity and Magnetism	Phys. 2C Physics-Fluids, Waves, Thermo, & Optics
AMES121A Mechanics I: Statistics	AMES121B Mechanics II: Dynamics
Check the Upper Division Classes you have completed:
BE 110 Continuum Mechanics	BE 172 Bioengineering Laboratory
AMES 103A Introductory Fluid Mechanics	AMES 103B Mass Transfer
BE 122A Biosystems & Control	BE 122B Biomedical Electronics
BE 112A Biomechanics	BE 112B Biomechanics
BE 140A Bioengineering Physiology	BE 140B Bioengineering Physiology
BE 186B Principles of Bioinstrumentation Design	BE 186C Bioengineering Design
List any technical electives you have completed:
Quarter(s) you would prefer to do an internship:	Fall    Winter    Spring    Summer
Year you would prefer to do an internship:
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