| Full Name: |
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Phone: |
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| Job Title: |
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Extension or Direct Line: |
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| Organization Name: |
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Fax: |
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| Street Address: |
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E-mail: |
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| City: |
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Website URL: |
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| State: |
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Career Field: |
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| Zip: |
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Number of interns my organization is willing to host: |
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Organization Description:
Please write a descriptive paragraph that sells your organization to students. |
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| Externship Information: |
| I am willing to
host a UGA student as an intern during: |
Late Oct - Early Jan
Mid March - May
Flexible |
| How many UGA interns are you willing to host? : |
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| I am willing to
host a UGA student for: |
1/2 Day
1 Day
Flexible
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| During the following time period: |
Morning
Afternoon
Flexible (student arranges with you)
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| Location of the intern visit: |
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| Class range of student: |
1st year
2nd year
3rd year
4th year
Grad Student
Flexible |
| Major(s) requested: |
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| I agree to the terms of the UGA Intern For A Day Program: |
Yes |
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In the space below please provide us with a brief description
of the intern's duties:
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Quicklinks
