General Description of activities, programs or projects in which intern will participate:

Role and responsibilities of the intern in these activities.
Internship dates. From: to: . Hours per week: .

Your related intern skills or requirements (computer skills, car etc.):

Submitted by: Date:

Company or Agency:

Telephone: eMail:

Address:

Immediate Intern Supervisor: Title:

Address and Phone, if different from above:

Or mail to:
Internship Coordinator
Department of Geography
The University of Georgia
Athens, GA 30602-2502