* 1. Student Name:

* 2. Student Phone:

* 3. Student Email:

* 4. Are you...

* 5. What is your major?

6. In what industry(s) are you interested in interning?

* 7. Why are you interested in entrepreneurship?

8. Do you have reliable transportation?

* 9. How many hours per week are you looking to intern?

* 10. What is your availability?

11. What kind of internship are you willing to take?

12. Are you a member of the Chapman EClub (Entrepreneur Club)?

Please select one of the internships listed on the Leatherby Intern Board located here: http://chapmanleatherbyinternships.wordpress.com/ and answer the following question.

13. What internship(s) listed on the Leatherby Center Internship Listing are you interested in?

14. Any further comments or questions relevant to your application: