Internship Acceptance Form
Please complete this form AFTER you have confirmed that you have been accepted at your internship site.
First Name *
Your answer
Last Name *
Your answer
PSU Access ID (first part of email address) *
(i.e. abc123)
Your answer
Academic Level *
How did you find your internship? *
check all that apply
Required
Major at Brandywine *
Email address
(if providing PSU address, please type out @psu.edu )
Your answer
Mailing Address
Your answer
Cell Phone Number
Your answer
Completing Internship: *
Semester(s) registered for internship *
Required
Year(s) registered for internship *
Required
Anticipated Graduation Semester *
Anticipated Graduation Year *
Your title/function at internship *
(i.e. Marketing Intern, Sales, Human Resources, Case Manager, etc.)
Your answer
Organization Name *
Your answer
Organization Department
Your answer
Work Site City *
Your answer
Work Site State *
Your answer
Supervisor Name *
Your answer
Supervisor Title
Your answer
Supervisor Phone
Your answer
Supervisor email
Your answer
Type of Organization
Type of Internship
Internship Course *
Number of credits being earned
(i.e. HDFS = 9)
Your answer
Are you being paid / compensated for your internship? *
Amount paid
(enter 0 if unpaid - please enter numbers only without $, per hour, etc.)
Your answer
amount indicated is:
Internship Coordinator *
Submit
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