Please read the PHSC Catalog/Handbook about the internship program before filling out this request form. It contains important information on prerequisites to the internship program, and general information about the program.

Student Internship Request

About You
Name
Address
About You
PHSC Major
Business occupations in which you would like to have an internship experience in order of preference
First Choice
Second Choice
Third Choice
Additional Information
Signature and Agreement

I am aware that participation in the internship program is contingent upon meeting minimum eligibility requirements as stated in the PHSC Catalog/Handbook, and that I am responsible to apply to internship websites order to find an internship site.

Date: May 14, 2026