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Intern with Stand Up Survivor
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First and Last Name
Phone Number
Email Address
Date of birth
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What College/University do you attend
Year in School
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List the beginning and end dates you want to do an internship
List the days and times you are available?
What is your current major/area of study?
Describe any student organizations, job experiences, additional course work (undergraduate or graduate), skills, degrees, certifications, or licenses that you have that will help you with this internship.
When do you expect to graduate
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What area do you think that you would be interested in:
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