Information about the interning organization

Interning Company/Organization Information

By providing this you are confirming that the company/organization at which you will do your internship and your mentor at the organization have agreed to participate in this project. They will be contacted by us to confirm this arrangement.

Company/Organization Name ■

Address ■

Supervisor ■

This is the person at the interning organization who has agreed to mentor you and provide an evaluation of your work at the end of the semester. Be sure that the supervisor has agreed to do this before you submit this application.

Supervisor Phone Number ■

Email (of your Supervisor) ■