Organization:      

Contact Person:  

Phone: 

FAX:   

Email: 

Work Location (address):

Website for organization and/or internship information: 

Would this position be paid or volunteer?         Paid            Volunteer

                      If paid, what would the hourly rate be? 

Please provide a brief description of the responsibilities of the intern, including the expected time commitment (for example, 20 hours/week for one academic year). You might also include any relevant restrictions or preferences (preference for students with a specific major, for instance).