Your Name & 9-digit school ID#

School & Academy Name: Business, Engineering, or Medical

Employer Name (Name of Company)

Internship Address (or list if virtual)

Supervisor Name (Name of Person)

Supervisor Email & Supervisor Work Phone Number

Internship start date

Internship end date (select the due date if you are still working)

Compensation: paid or unpaid

Number of hours worked

Work Experience

A Deeper Look At My Work Experience

Verification & Evaluation