Career Connections - Report Jobs - Students - Internships

Employer Information:
*Employer/Business Name:


*Employer Contact Name:


*Employer Contact Email:
Employee/Student Information:
*Student's Full Name:


Student's CWID (if known):


Student's Email Address:


*Student's Major:


*Student's Estimated Graduation Date (month / year):
Employment Information:
*Business/Organization Name:


*Name of Intern's Supervisor:


*Employer's Street Address:


*Employer's City, State, Zip:
City: State: Zip:

*Intern's Job Title:


Month/Year Started:

Month/Year Stopped:

Is this internship for academic credit?

Employee's Salary Information (Confidential - for group salary data only)

*Please select the value that most accurately reflects the employee's salary:


* denotes a required field.