EMPLOYER Reported Internship Placement Survey

Please provide the following company and contact information: Your Name:
Company:
Address:
Address 2:
City/Town:
ZIP:
COUNTY:
Your Email Address:
Your Area Code & Phone Number:

Full name of intern

Intern's college/university

Major

Job title of the internship

Salary/compensation (amount paid per hour, stipend value,
scholarship, credit, unpaid, etc.)

Start date of internship

End Date/Duration of internship

Would you re-hire or recommend this intern? Why or why not?

Please provide any additional comments you would like to share (about this internhip, about
your experience with the NEOintern database, etc.)

Thank you for taking the time to report this information about your intern.

EMPLOYER Reported Internship Placement