Social Impact Internship Form (Part I)

Name(Required)

First Last

BU ID (U12-34-5678)(Required)

Student Email(Required)

Internship Employer/Organization(Required)

Internship Focus Area and/or Title

Internship Address

Street Address Address Line 2 City State ZIP Code

Supervisor Name(Required)

Supervisor Title

Supervisor Email(Required)

Supervisor Phone #

Start Date(Required)

End Date(Required)

Acknowledgement(Required)

I understand that in addition to the academic requirements of the Social Impact Program, I am expected to complete an approved 300-hour internship. I certify that the information provided in this form is true to the best of my knowledge and I have fulfilled all duties as assigned.

Letter or Email from Internship Supervisor

Max. file size: 128 MB.

Please upload a letter or email from your internship supervisor, confirming your performance of the previously submitted duties and expectations, and completion of your pre-approved 300 hour internship. Emailing or delivering this to Brad Czarnowski (bczar@bu.edu) in the Grad Center will also suffice.

Additional Information (optional)

If applicable, please include any additional information you would like to share with the Graduate Academic & Career Development Center regarding your internship application.

Social Impact Internship Form (Part I)

MBA CENTER

SPECIALTY MS & PhD CENTER