2018 Faculty Form

DSIP 2018 Faculty Internship Position Form- Due Feb 1

Please complete the following form with details about your internship description. Please complete a separate form if you have multiple positions (differing titles and responsibilities). Thank you!

Question Title

* 1. Title/Number

Internship Title

Maximum Number of Interns for This Position

Question Title

* 2. Department/s and/or Center Affiliations

Question Title

* 3. Primary Faculty Mentor's Name (Please include credentials, or titles you'd like included in program publications)

Primary Faculty Mentor's Last Name

First Name

Credentials

Phone #

Campus Mailing Address

Location where intern is to report for work if different from campus mailing address

Question Title

* 4. Secondary Faculty Mentor's Information (Please include credentials, or titles you'd like included in program publications)

Last Name

First Name

Email Address

Phone #

Question Title

* 5. Project Background Description

Question Title

* 6. Intern Duties and Responsibilities

Question Title

* 7. Desired Qualifications/Skillset

Question Title

* 8. Please list any articles/readings/ resources which would help prepare and orient the student to your project.

Thank you! We will be in touch to confirm receipt of your project proposal.