COMPANY NAME:
ADDRESS:
CITY:		STATE:		ZIP:

SUPERVISOR'S NAME:
SUPERVISOR'S TITLE:		PHONE:
E-MAIL:		FAX:

1. Have you ever applied for an intern through our office before?     YES NO

If yes, what semester?:	Year:
If multiple times, please list:

2. What type of work does your company do?

3. Approximately how many employees does your company have (all locations)?   

4. In what department will the intern work?   

5. How many employees does the department have?   

6. From what academic major are you interested in having an intern?
    Accounting   Management   Finance   Marketing   International Business   Pre-Law

7. What semester would you like to have an intern?
    Fall   Spring   Summer   Every semester (continuously)

8.What days of the week and hours are the most convenient for you to have the intern work?

9. Please list the major tasks that you anticipate the intern doing.