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Step 6: Required Forms

The following forms are required for applicants to the Utah State University Dietetic Internship and without them the applicant's application is considered incomplete. Incomplete applications will not be reviewed. These forms are not to be submitted with the DICAS application.

Program Application Fee Form— updated 10/30/2017
  • This form and the check or money order will be sent through the mail. It must be postmarked by February 15, 2018. Pre-select applicants postmark deadline is Friday, January 5, 2018.
  • The application fee is non-refundable.
  • The program application fee form and fee payment will be mailed to USU Dietetic Internship, USU-SLC, PO Box 57322, Murray, UT 84157.

All internship applicants need to complete and submit a Rotation Summary Form. Select ONE form from the options below that describes what type of applicant you are: 
Rotation Summary Form — outside of Utah
Rotation Summary Form UT — Utah/Utah-Hybrid ONLY 

All internship applicants will ask their preceptors to complete the following two forms:
Facility Form
Preceptor Form

If you are using a USU provided database which indicates we already have the forms on file, you do not need to submit these forms with your application. 

If you are concerned because your preceptor has not returned the Facility Form or the Preceptor Form and the application deadline is approaching, please contact the USU DI.

Instructions for emailing preceptor paperwork:

  • Save files as a PDF.
    • File Name: LastNameFirstNameNameOfForm (example: smithjanepreceptorform.pdf or smithjanerotationsummaryform.pdf)
  • Please send ONE email with ALL forms attached.
  • Send to:
  • Subject line: last name, first name, DICAS #
  • These forms must be sent by the application deadline of February 15, 2018. Pre-select applicant deadline is Friday, January 5, 2018.

Step 5: D&D Digital Instructions                Back to How to Apply