Background Information:
Full Name: Phone:
Job Title: Extension or Direct Line:
Organization Name:
Street Address: E-mail:
City: Website URL:
State: Career Field:
Zip: Number of interns my organization is willing to host:
Organization Description:
Please write a descriptive paragraph that sells your organization to students.
Intern for a Day Information:
I am willing to host a UGA student as an intern during: Late Oct - Early Jan (Fall Semester)
Mid March - May (Spring Semester)
Flexible
How many UGA interns are you willing to host? :
I am willing to host a UGA student for:

1/2 Day 1 Day Flexible

During the following time period:

Morning Afternoon Flexible (student arranges with you)

Location of the intern visit:
Class range of student: 1st year 2nd year 3rd year 4th year
Grad Student Flexible
Major(s) requested:

In the space below please provide us with a brief description of the intern's duties:

Please enter the word you see in the image below: