Moorpark College Career Services
Internship Request Form

Business/Organization:
Contact Person/Title:
Phone(s): Fax:
Address:
Webpage: Email:
Type of Organization:
No.Students Requested: Days: Hrs/Week:
Semesters:F________Spr________Sum_______All_______
Compensation: Paid_____ (Rate $______________/hr); Unpaid__________ Stipend__________________
Other (please explain):
Job/Internship Title:

Duties and Responsibilities of Employee/Intern:

 

 

Basic Qualifications required (Special skills, experience, academic background, etc.)

 

 

Training provided by organization:

 

 

Additional Comments:

 

Please print form and return to:
Career Services, Moorpark College
7075 Campus Road
Moorpark, CA 03021-1695

Or Fax to:

(805) 378-1465