All items marked with * are required.
Student Name (First, MI, Last)*: Major: Year of Graduation: Telephone Number: E-mail Address:
Employer Name: Location: Dates of Internship: Type of industry/brief description: Tell us about your experience. What were your duties and responsibilities? What special skills or qualifications are necessary for this internship? (Example: Junior or Senior status, computer skills, GPA requirements, etc.)What was your favorite aspect of this job or internship? Your least favorite?
Compensation (please check one):VolunteerWageStipendOther perks: How can other students apply?Contact Person: Address: E-mail Address: Phone Number: Fax Number: Other networking contacts: (Example: alumni, your supervisor. It's always helpful to include information such as phone numbers, addresses, and preferred contact method)Other comments:Are you willing to share your contact information (your name, phone, e-mail, etc.) with other students? Yes No