CCCSI Internship Outtake Survey

CCCSI Internship Outtake Survey

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1. Default Section

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1. Date:

	Semester	Year
Current Semester/Year	Date: Current Semester/Year Semester	Year

*

2. Student Demographic Information:

Student Demographic Information: Name:
Student ID #:
Preferred Email Address:
Preferred Phone Number:

*

3. This was for

This was for Class-based Internship Volunteer	Work-Study Pitzer Social Responsibility Requirement
Other (please specify)

4. What kind(s) of compensation did you get for your internship?

What kind(s) of compensation did you get for your internship? Paid Academic Credit	Fulfilled Graduation Requirement No compensation
Other (please specify)

5. Site demographics

Site demographics Site Name:
Site Website:
Supervisor Name:
Supervisor Email Address:
Supervisor Phone Number:

6. How did you locate your site?

How did you locate your site?

7. Time commitment

Time commitment Approximately how many hours per week did you with with your site?

8. Intent to continue with site:

	Yes	No	Maybe
Do you plan to continue working with this site?	Intent to continue with site: Do you plan to continue working with this site? Yes	No	Maybe
Would you recommend an internship at this site to other Pitzer students?	Would you recommend an internship at this site to other Pitzer students? Yes	No	Maybe

9. If this was for a class-based internship:

If this was for a class-based internship: Professor Name:
Class Title:

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