CCD Home
Externships Home
General Info Homestay info
Financial info
Application info Selection info
Sharing the experience
Sponsor an externship

Center for Career Development : Discovery Externships : Enrollment Form

Ready to sponsor an externship? By completing and submitting this form to the Center for Career Development, your Discovery Externship will be printed and promoted in the Discovery Externship Catalog for Summer 2008.

Alternative PDF format is available if you prefer to print it out and mail or fax it in.

Section I - Basic Information
Employer Organization Name
Department(s)
Ownership Type Private Public Non-Profit Gov't. Education Other
Organization Size
Organization URL Address
Title
Employer Address
City
State ZIP
Employer Telephone
Employer Fax
Alumni Sponsor Name
Class Year
Home Address
City
State ZIP
Home Telephone
Preferred E-mail Address
Preferred Method of Contact Email   Work Phone   Home Phone   Fax
Preferred Method to Receive Paperwork Email   Fax

Section II - Position Information
Title of Externship Position
Number of Positions Available 1 2 3 4 Other
Duration ( # of weeks) 1 2 3 4 Other
Additional G.P.A Requirement needed other than 2.0 or higher? Yes No     If yes, min. G.P.A. needed:
Additional Application other than cover letter/resume needed? Yes No
If yes, is the application material on file? Please submit if needed. Yes No
Description of Position Responsibilities including Possible Focus Project Ideas
Position Requirements/Desired Skills

Section III - Logistics Information
Is the position paid? Yes No Sometimes (Depending on Projects)
If yes, what is pay rate or stipend? $ per Hour Week Month
-- or --
Externship Stipend $
Can you sponsor the Homestay? (If Yes, please complete Section IV. If No, possible suggestions for other alumni Homestay hosts?) Yes No
Federal Work Study Eligible Site? (Email us at career@kzoo.edu for more info.) Yes No
Can you provide Transportation to/from work site? Yes No
Referrals of other Alumni who may be interested in learning more about hosting a Discovery Externship

Section IV - Homestay Information

Please share a description of your lifestyle & avocations below. This will be shared with the extern before the experience so that s/he can become acquainted with the nature of your home, family situation, as well as occupations, hobbies, interests, habits/quirks, etc. You are encouraged to submit a photo of yourself and/or family.
Names of Family Members: (Including ages of children at home)
Lifestyle
Home: Do you have any pets? Yes No
If yes, how many/what kind?
Will you provide meals to the extern? Yes No
If yes, how many per day? 1 2 3
Please describe the environment of which the extern will be surrounded (i.e. 1 private bedroom room, shared bath, etc.
Additional Information