EmailMe Form - Child Development Internship Permit Request

Name
First Last Suffix
UM Email Address *
Student U number
Academic Advisor *
How many credit hours have you earned towards this degree? *
Expected Graduation Date *
Internship Semester *
Select (1)
Internship Type
Early Childhood Classroom
Medical Agency (location will be determined by faculty)
CDFS Agency (location to be determined by faculty)
Select (1)
Internship Preference
Barbara K. Lipman Early Childhood School & Research
Maria Montessori School
U of M Child Development Center
Other
Please indicate your Monday - Thursday available times based on your class/work schedule.
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