Winter Externship - Registration Form

2007 Winter Break Externship Program

December 10-14 , 2007 ~ Student Registration

Career Services & Experiential Learning

Registration Form

* A Winter Externship is a one-day to a weeklong, voluntary job shadowing experience. The Externship gives UCF students an opportunity to experience firsthand what it is like to be a professional in a career they are interested in pursuing. Students spend time observing and often working with an employer host in order to gain some insight into the real world aspects of their future careers. The UCF Winter Externship experience takes place each year during the UCF Winter Break.

First Name:*

Last Name:*

Street Address: *

City:*

Zip:*

E-mail Address:*

Contact Phone Number:*

International Student? *

	Yes
	No

Major:*

Minor:

Class Standing:*

	Freshman
	Sophomore
	Junior
	Senior
	Graduate

Graduation Year:*

Career Interests:

Have you participated in any other externship program? *

	Yes
	No

Please list any other cities where you would be able to do an externship. (NOTE: You must have a place to stay and your own transportation in these locations.)

Did You attend an information session on the Externship Program? *

	Yes
	No

Emergency Contact Information

Name:*

Relationship:*

Contact Phone Numbers:

(Home)

(Work)

(Cell)