Name:

Email Address:

Major:      Degree:

Graduation Date:

Job Title:

Job Type: Internship    Summer Job    Part-time Job

Did you receive academic credit? Yes    No

Was this Experience Related to Your Major? Yes    No

Work Location:

Payment: Unpaid    Hourly Rate   Salary   or Stipend

How did you find out about this opportunity?
CDC
Job Hotline
Faculty Announcement
Flyer
Alumni
Other:

Employer Information:

Employer's Name:

Supervisor or Contact Name:

Supervisor E-mail (if unknown, type unknown):

Supervisor's Title:

Employer Address:

City: State: Zip Code:

Work Phone Number: Work Fax Number:

Website Address:

Comment on your interaction with the Career Development Center:

Suggestions/ideas for improved and/or additional services: