Internship Development Request
Contact Name *
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Email *
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Contact Number *
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Company Name *
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Internship Title *
Your answer
No. of Open Intern Positions *
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Intern Responsibilities *
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Intern Hours *
Required
Major(s) Preferred *
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Required Coursework Completed
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Required GPA
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Start Date
MM
/
DD
/
YYYY
End Date
MM
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DD
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YYYY
Compensation *
Please identify 1 to 3 learning objectives for the Intern *
(i.e. To serve clients and improve customer service/interaction by August 27)
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Would you like the Career Center to assist you in identifying learning objectives? *
Any other comments/info
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