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Internships and Project Information Request Form

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Your Information Name Professional Title Email Address Your Primary Phone #

Business Information Company Name Address City State Zip Code Company Phone # Company Website Please describe your company:

Which Categories Apply to your Business? »

Advanced Manufacturing
Health & Life Sciences
Logistics
Information Technology
Nonprofit
Other
If "Other", please describe your business

Internship Information Please describe your project or need: Desired Skills and Qualifications (Include GPA, year in school, software skills, etc.) Majors Preferred (View a list of majors) How will the students be monitored? By Whom?

Do you have a staff / Board Member in this area of expertise? »

No Staff Expertise
Yes we have staff with Expertise

Estimate total hours of work needed Location (City) Preferred Start Date (DD/MM/YYYY) Do you have funding for this project? Please explain below.

Submit Please review all information before submitting.

IUPUI

Contact the Solution Center

Internships and Project Information Request Form

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