Butterfly House School Advisor Information
Intern Evaluation courtesy of the Butterfly House, Chesterfield, MO
Download the original form as a Word File.
School Advisor Information
Intern Name: __________________________________ Internship Area: ______________________
School: ______________________________________________________________________________
Advisor’s Name: ________________________________ Phone: ______________________________
Advisor’s email: _______________________________________________________________________
Advisor’s mailing address: _______________________________________________________________
_______________________________________________________________
Last Day of Internship: ___________________________ # of hours needed: ____________________
How many credits received (total and # per credit hour): _____________________________________
Forms needed by school:
Please attach a copy of your internship requirements.
—————————————————————————————–
All About You
Name
Nickname
Are you in college? What year (i.e. Freshman)?
School
Major/Minor
Hobbies/interests/Pets:
Most unusual thing you ever did:
Anything else you would like to share with our volunteers/staff?