Employer Verification Form
For internship supervisors of student interns enrolled in Media Internship (MS 196 PZ) through Intercollegiate Media Studies of the Claremont Colleges. If you have any questions about the form or the course, please contact Elizabeth Affuso, IMS Academic Director, at eaffuso@pitzer.edu.
Name of Company or Organization: *
Your answer
Department:
Your answer
Company Address: *
Your answer
Website:
Your answer
Student Intern: *
Your answer
Site Supervisor: *
Your answer
Supervisor Phone: *
Your answer
Supervisor Email: *
Your answer
Approximately how many hours of work did the student complete? *
Your answer
Did the student satisfactorily fulfill his/her duties? *
Your answer
Any other relevant information/comments?
Your answer
Would you be willing to accept another intern from the Claremont Colleges? *
Your answer
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