College of Engineering
University of South Florida

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We are seeking information on your internship, co-op, and study abroad experiences. Your assistance will enable us to assist both current and future USF engineering students.

1.	First Name

2.	Last Name

3.	USF ID Number:

4.	USF Email Address:

5.	Gender
	Male Female

6.	Major

7.	Program Year

8.	Have you participated in an experiential learning opportunity (internship, co-op, part-time employment, study-abroad, etc.) while at USF?
	YesNo

9.	If yes to question #8, please indicate how many semesters

	We are seeking information for Fall 2010, Spring 2010, and Summer 2010. If you have participated or plan to participate in an internship, co-op, or study abroad experience during these terms, please complete the appropriate information below: Fall 2010 Information: #10 to #15

10.	Company/Organization/Sponsor:

11.	Name of Supervisor:

12.	Email Address:

13.	City:

14.	State:

15.	International:

16.	If yes to #15, please write where:

	Spring 2011 Information: #17 to #23

17.	Company/Organization/Sponsor:

18.	Name of Supervisor:

19.	Email Address:

20.	City:

21.	State:

22.	International:

23.	If yes to #22, please write where:

	Summer 2011 Information: #24 to 29

24.	Company/Organization/Sponsor:

25.	Name of Supervisor:

26.	Email Address:

27.	City:

28.	State:

29.	International:

30.	If yes to #28, please write where:

31.

How did you learn about the internship/co-op/study abroad position(s)?

USF Career Center

College of Engineering department

USF Engineering faculty

USF Study Abroad

Engineering Student Organization

Company/Organization’s Website

Other, please specify

32.	Please feel free to share any comments regarding your experience (All comments will be confidential).

College of EngineeringUniversity of South Florida

College of Engineering
University of South Florida