Environmental Studies Internship Application

Environmental Studies 385 - Internship Placement Information

Please fill out this form with all of the appropriate information regarding internship placement. This form must be filled-out prior to meeting with Dr. Kamp for internship approval.

Personal Contact Information

Your Name*

First Name

Last Name

Address*

Address Line 1

City

State

ZIP Code

Email*

Phone*

Internship Placement Information

Name of Organization*

Type of Organization

Business/Corporation Educational Government Non-profit

Organization Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Department*

Phone*

Name and Title of Supervisor*

Supervisor Email*

Start and End Date*

Total Number of Weeks*

Days of the week*

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Check all that apply

Number of hours per day*

Total number of hours per week*

Provide a brief description of your internship. What do you expect your duties to be? What kinds of projects do you expect to be working on?*