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 Courtney Aloul [email protected] or (616) 331-6249

* denotes a required field

Company Information

Company Name *

Company Address Line 1 *

Company Address Line 2

City *

State *

Zip Code *

Site Contact Information

Contact First Name *

Contact Last Name *

Title

Email *

Phone *

Internship History

Have you previously hired a GVSU safety and health intern? *
No
Yes

Internship details

Start Date *

Please provide a brief description of the scope of work and/or projects: *

Will the intern be required to travel beyond regular commutes to and from the site? *
No
Yes

Estimated Internship Duration (Check all that apply) *
Summer Full time
Fall Part time
Winter Part time
Not listed Please specify a value for Estimated Internship Duration (Check all that apply)

What is your preferred means of application *

Human Verification *

Page last modified March 17, 2022

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