CHME Co-op/Internship Survey

Co-op/Internship Survey Form

To help CHME better serve students, the department is developing a database of information about co-op and internship experiences. If you had a co-op, internship, REU, or other paid position, please complete this survey. Your personal information will not be associated with your name when results are made available.

Name
First Last
Which is the highest CH E(s) course you have completed (at the time of your co-op/internship)? Only select if you have completed both courses named on a row.*
Employment Start Date*
Date Format: MM slash DD slash YYYY
Employment End Date
Date Format: MM slash DD slash YYYY
Company*
Rate of Pay ($/hr)*
City*
State
Job Responsibiliies
Briefly describe your responsibilities during your work session. Also describe any project work you performed, if you are free to talk about it.
I completed this employment while enrolled in CH E 391
- true
Other benefits
- living accommodations provided
- greatly reduced living accomodations
- living allowance
- cell phone allowance
- relocation expenses paid in full
- relocation expenses partially paid
- tuition reimbursement
- other
Phone
This field is for validation purposes and should be left unchanged.