Internship Site Information Form

Please complete this form to request an intern from the GVSU Occupational Safety and Health Program.  Once the request has been submitted, eligible students will be informed of this internship opportunity.

If you have any questions, please contact Derek McCormick at mccorder@gvsu.edu or (616) 331-2649

* denotes a required field

Company Information


Site Contact Information

Internship History

Have you previously hired a GVSU safety and health intern? *

Internship details

Start Date *

Will the intern be required to travel beyond regular commutes to and from the site? *

Estimated Internship Duration (Check all that apply) *