Qualtrics Survey | Qualtrics Experience Management

Note: This form cannot be used to create internships. If you have a student who would like to complete an internship with you, please have them contact their program's internship coordinator- Jeff Heinzl (PPW, Lit, Writing, DNID) or Mark Best (Film). The internship coordinator will complete a Learning Agreement with the student and their site. After it has been completed, they will send it to Lori Campbell Tanner to register the student for the internship credits. No Response is needed to this question

Term of Enrollment

Summer 2025
Fall 2025

Faculty Member Name

Faculty Email

Student Name

Student ID Number

Course Program

PPW
Literature
Film
Writing