Internship Program Closure Checklist Form
Confirm completion of all end-of-internship tasks and provide final administrative details for program closure.
Intern's Full Name
*
First Name
Last Name
Department or Program
*
Internship End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Checklist of Closure Tasks (mark all completed tasks)
*
All company property/assets returned
Final report/project submitted
Exit interview completed
Feedback form completed
Email and system access deactivated
Other (please specify)
Please specify any additional closure tasks completed (if any)
Supervisor/Coordinator Name
*
Date of Checklist Completion
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Additional Comments or Notes
Submit Checklist
Should be Empty: