Submitted by QIP4 on Thu, 12/13/2018 - 11:30 Name * Email * Telephone * Program, Major, and Minor * Adviser * Choose two areas you are most interested in * Social Entrepreneurialism Human Security & Development Education & Special Education Social Development Health & Rural Income Hidden Peoples Micro-Credit & Sustainability Gender Violence Homeless Children Agriculture & Food Refugees Other What kind of internship are you interested in? * Research Based Internship Project Based Internship Other What would you like to get out of the internship and why? * Do you know what organization you wish to work with? * Yes No Please name the organization(s) * Have you ever lived abroad? * Yes No Please list where and why? * Do you have any special accommodations or needs while traveling? * Yes No What accommodations? * Do you plan to apply for funding? * Yes No Which funding sources? * Current state and federal child clearances? * Yes No CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit