Internship Program


Indiana University South Bend
Department of Mathematics & Computer Science
1700 Mishawaka Avenue, P.O. Box 7111
South Bend, IN 46634-7111
Tel: (574) 237-4517, Fax: (574) 237-6589
internship@natasha.iusb.edu

(Student Application)

 
Name:_____________________              Date: ________/_______/__________

Address: __________________________ SS#:_______________________

City:_____________ State:___ Zip:_______ Tel: _____________________(Work)

Hours available to work:__________ E-mail:_________________________ WWW: ___________________________

Classification:(circle one) Freshman Sophmore Junior Senior

Overall GPA:_________ Computer Science GPA: _________

Courses Taken:

CS Math Other

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Work Experience: (short description)

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Student Signature Date

Note: