This website uses scripting to enhance your browsing experience.
Enable JavaScript
in your browser and then reload this website.
This website uses resources that are being blocked by your network. Contact your network administrator for more information.
2023 Internship Supervisor Completion Form
Loading...
Thank you for sponsoring an internship for one of our Undergraduate Scholars. Please complete the information below and submit by September 10, 2024. If you have any questions you can contact us at scholars@jkcf.org. Your signature below verifies that the information shared in this report is true and accurate.
Scholar Name:
Organization Name:
Organization Address:
Was the internship in person, virtual, or hybrid?
Was the internship in person, virtual, or hybrid?
In person
Virtual
Hybrid
How many hours did the scholar complete during the internship?
320+ hours
Less than 320 hours
Optional question to help us with future planning:
Are you interested in supervising Cooke Scholars for internships in the future?
Optional question to help us with future planning:
Are you interested in supervising Cooke Scholars for internships in the future?
Yes
No
Would you be interested in attending an event where your intern(s) will give a presentation on the work they do under your supervision along with other Cooke Scholar interns from other sites? Please check all that apply.
Would you be interested in attending an event where your intern(s) will give a presentation on the work they do under your supervision along with other Cooke Scholar interns from other sites? Please check all that apply.
Yes, if it's virtual
Yes, and I'm willing to travel
No
Supervisor's Name:
Supervisor's Title:
Supervisor's Phone Number:
Supervisor's Email Address:
Supervisor's Electronic Signature:
Date:
Submit