Faculty Request to Start a Placement Site

Please describe the potential of the site to have educationally appropriate experiences for our students and how the internship/service learning experience supports the student’s academic study. *

Please include or attach a brief description of the work the students will complete during the experience. Include any special skills or selection requirements. *

Do you perceive any potential risks for the student at the site? For example, will the student be working with clients that pose a high risk or will the student be working with heavy machinery? *

Have you visited this site?

Yes

No

When did you visit the site?

Month

Day

Year

Have you done a web review of this site?

Yes

No

When did you complete a web review of the site?

Month

Day

Year

Have you previously placed students at this site? *

Yes

No

How long were students placed at this site? *