Name: ____________________________________________________________________________

Present Address

Phone Number ___________________ Email ___________________________________________

Semester that Internship will be completed (please check one) _____ Summer _____ Fall 2007

Hours remaining for graduation at end of this semester: ___________________

Major: ____________________________________________________________________________

If you have already located an internship where is it? _______________________________________

With what firm or agency is it with? _____________________________________________________

Complete the following only if you are looking for an internship:

Location Preference(s): __________________________ __________________________________

Major Courses:

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

Honors & Activities:

References:

Please attach a record of your grades (for faculty use only!).