Employer Data Form

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Employer Data Form

Thank you for hiring an intern from Northern Illinois University. Please assist us in ensuring the position meets the criteria for academic credit. Complete this form e-mail mburlingame@niu.edu from your organization email for verification.

Email *

Name of Intern *

First and last name

Name and description of the Company. *

Include its size, mission, and location.

Internship objectives and primary duties. *

What will the student learn from this experience? *

What kind of training or orientation will be provided? *

Start Date of the Internship *

YYYY

End Date of the Internship *

YYYY

How many hours do you anticipate the student working? *

Who will serve as the student's primary supervisor? *

Name and Title

Describe the types of documents, articles, or artifacts (web links/videos), if any, the student will create for inclusion in a final portfolio. *

How will the intern be evaluated? *

Any comments you feel relevant or necessary to evaluate this internship for credit. *

Name and Title of the person providing this information. *

Submit

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