Student Data Sheet Template Page 2

Please indicate the internship/service learner opportunity you are interested in based on the current

needs:

Why do you want to be an intern/service learner with Sojourner Family Peace Center?

What are you looking to achieve in this internship/service learner opportunity?

Please indicate the requirements for your program.

Hours needed:

Supervisor qualifications:

Please indicate the times that you are available:

M _______ T _______ W _______ Th _______ F _______ Sat. _______ Sun. _______

Please state how many hours a week you are looking to commit to: _______________

Please select which semester you are looking to begin:

Spring Semester ___________ Fall Semester ___________ Summer ___________

For what period of time: ______ Semester(s)

Would you like to be added to our mailing list:

FORM595B - Student Data Sheet

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Parent category: Business