HSSP Approval Form

Please email Andrew Hart (andyhart@brandeis.edu or andrew.robert.hart@gmail.com) to let him know you have completed this form. You must receive written approval for your internship to count towards your HSSP HOE requirement.

    STUDENT INFORMATION

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    INTERNSHIP SUPERVISOR/MENTOR INFORMATION

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    INTERNSHIP PLACEMENT INFORMATION

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Please email Andrew Hart (andyhart@brandeis.edu or andrew.robert.hart@gmail.com) to let him know you have completed this form. You must receive written approval for your internship to count towards your HSSP HOE requirement.