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I Want to Provide a Summer Internship/Job for Summer 2012
All fields with an asterisk (*) are required.
First Name: *
Last Name: *
Status: *
Parent
Alum Class of
Friend
Address: *
Apt/Suite
City/State/Zip: *
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AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
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MO
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Home Phone:
Email:
Occupation: *
Area of Expertise:
Name of Business/Organization: *
Business address: *
Apt/Suite
City/State/Zip: *
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Business phone: *
Business email:
Business fax:
I am interested in providing a Summer Job(s) or Internship(s) for Horace Mann School seniors or college-age graduates
Although I cannot provide an internship, I suggest you contact:
Please briefly describe the position(s) or internship(s) you would be willing to offer, as you would like it to be listed by us:
Job 1 Title:
Wage(amount)
Non-paying internship
Stipend for
Description:
Special Requirements:
Other Comments:
Are you willing to hire or host more than one student?
Yes
No (If yes, how many?)
Job 2 Title:
Wage(amount)
Non-paying internship
Stipend for
Description:
Special Requirements:
Other Comments:
Are you willing to hire or host more than one student?
Yes
No (If yes, how many?)
Job 3 Title:
Wage(amount)
Non-paying internship
Stipend for
Description:
Special Requirements:
Other Comments:
Are you willing to hire or host more than one student?
Yes
No (If yes, how many?)
Job 4 Title:
Wage(amount)
Non-paying internship
Stipend for
Description:
Special Requirements:
Other Comments:
Are you willing to hire or host more than one student?
Yes
No (If yes, how many?)
Job 5 Title:
Wage(amount)
Non-paying internship
Stipend for
Description:
Special Requirements:
Other Comments:
Are you willing to hire or host more than one student?
Yes
No (If yes, how many?)
Please submit this form before February 7, 2012.
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