1) Name of Host Organization: *

2) Address: *

3) Web site (if applicable):

4) Description of Organization: *

5) Number of Intern positions: *
One Two More

6) Name of Intern Supervisor: *

7) Supervisor's contact Information (both office and emergency): *

8) Position Title: *

9) Detailed Job Description (the more detail, the more qualified the applicants): *

10) Hours, duration and preferred dates: *

12) Dress Code: *

13) Any additional information that intern should know before arrival:

14) Qualifications of intern (both mandatory and preferred): *

15) Language proficiency *
N/A Beginning Intermediate Advanced
Other (please specify)

16) Materials/equipment intern should bring: *

17) Any support provided by host organization (i.e. transportation to/from airport; transportation during internship (train pass, etc.); living stipend; assistance with securing housing/homestay, etc.): *

19) We agree that MHC will select the most appropiate student(s) for this/these position(s) *
Yes
No, we prefer the following arrangement: