Please fill out this form in its entirety.
Name of Organization: *
Contact Person/Position: *
Phone Number: *
E-mail: *
Your email address will be kept private, but is needed for confirmation.
Brief description of organization/Link to website: *
Semester of internship: Spring 2012 Summer 2012 Fall 2012 Winter 2012 Spring 2013 Summer 2013 Fall 2013 Winter 2013
Work Location: *
Compensation (if any): *
Internship Responsibilities: *
Specific Projects:
Research Program evaluation Program development Personnel Financial analysis Policy analysis Strategic planning Other - Specify if other:
Preferred form of student inquiries and what information should be included:
Other Information:
Last Updated: 3/8/13
