Term Attending WE Course - Select -2025 Spring - Full Term2025 Spring - Late Start Term2025 Summer Term2025 Fall - Full Term2025 Fall - Late Start Term Student Information First Name Last Name COC ID# Email address Cell Number Program/major at COC Internship/Job Information 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 - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Company Zip Supervisor Name Supervisor phone Supervisor email Expected Start Date Is your position Paid Unpaid Is your position an internship? Yes No Average Weekly Hours you expect to work Total hours to be completed for term List your duties and responsibilities at this job/internship WE Course Information WE Course Title - Select -WE-486ARCH - ArchitectureWE-186AUTO - Automotive TechnologyWE-186BAKE Baking and PastryWE-186BUS - BusinessWE-186CAWT - Computer Applications & Web TechnologiesWE-186CNST – ConstructionWE-186CULA - Culinary ArtsWE-186EDUC - Elementary EducationWE-186ENVR - Environmental StudiesWE-186GMD - Graphic & Multimedia DesignWE-189GNR – GeneralWE-186HOSP Hospitality ManagementWE-186ID - Interior DesignWE-186MEA - Media Entertainment ArtsWE-186MFGT - ManufacturingWE-186NETW Network TechnologyWE-186PHOT - PhotographyWE-186PLGL - ParalegalWE-186REC - Recreation ManagementWE-186SIGN - Sign LanguageWE-186SSP Deaf-Blind Support Service ProviderWE-186THTR- Technical TheatreWE-186WELD - Welding Number of intended WE Units .5 (this option for WE-186ENVR, WE-186SIGN, WE-186SSP or WE-186REC) 1 2 3 4 Unpaid and Paid = 54 hours per unit over the course of the term Additional Information How did you find this position? Self-Procured Internship program Is your job or internship related to your major? Yes No What is your career goal? Are you a high school graduate? Yes No Are you over the age of 18? Yes No Are you an International Student in the United States with an I-20? Yes No Leave this field blank