Membership Declaration 2020-21

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Yes, I value the work of the Milwaukee Area College Internship Consortium and would like my school career/internship office identified as a member of MACIC for the 2020-2021 school year.

School Name *

College/University Address *

Office Phone Number *

Representative 1 Name: *

Representative 1 Title: *

Representative 1 Email: *

Representative 2 Name:

Representative 2 Title:

Representative 2 Email:

Representative 3 Name:

Representative 3 Title:

Representative 3 Email:

Representative 4 Name:

Representative 4 Title:

Representative 4 Email:

Please check the boxes below before submitting. *

I verify that I am an internship professional or faculty from a Wisconsin accredited post secondary educational institution

I agree to show active participation in the organization. Active participation may include representation on a commitee, attending or hosting at least 1 meeting, or holding elective office

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