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.

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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?