Internship Site Fact Sheet

Northampton High School Internship Site Fact Sheet Name of Site:_______________________________________________________ Primary Contact Person: ______________________________________________ Secondary Contact Person (if any): ______________________________________ Address: ___________________________________________________________ Mailing Address (if different from above): ________________________________ __________________________________________________________________ Phone number and Fax number (if any): _________________________________ Email Address: _____________________________________________________ Basic job description and/or expectations of potential NHS student intern: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Desire background/experience of potential NHS student intern: _______________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Is a resume required? Y / N Is an interview required? Y / N Name of student(s) currently hosting or have hosted in the past: _______________ __________________________________________________________________ Please return to: Donna Waterman Internship Coordinator, NHS 380 Elm Street Northampton, MA 01060 413-587-1332