CWE Course Application

Term Attending CWE Course

Student Information

First Name

Last Name

COC ID#

Email address

Cell Number

Program/major at COC

Title of job or internship

Is your job or internship:

Remote

In-person

Both In-person & Remote

Company Name

Company Address

If this is a remote/virtual internship or job, please provide the physical address for the company.

Company City

Company State

Company Zip

Supervisor Name

Supervisor phone

Supervisor email

Expected Start Date

Is your position

Paid

Unpaid

Is your position an internship?

Yes

Average Weekly Hours you expect to work

Total hours to be completed for term

List your duties and responsibilities at this job/internship

CWE Course Title

Number of intended CWE Units

Unpaid = 60 hours per unit, Paid = 75 hours per unit (over the course of a term)

How did you find this position?

Self-Procured

Internship program

What is your career goal?

Are you a high school graduate?

Yes

Are you over the age of 18?

Yes

Are you an International Student in the United States with an I-20?

Yes