University of Wisconsin-La Crosse
Department of Exercise and Sport Science
Internship Position Description
This form is not a contract and does not oblige the internship site/organization to accept any
applicant. A position description published by the site/organization may be used instead of this form.
Please feel free to attach additional pages and/or materials.
Student Intern:
Site Name:
Address:
Street
Phone:
(
)
Office
(
City
)
State
(
Zip
)
Fax
Other
E-mail:
Web Page:
Fall (Sept. – Dec.)
When is/are Intern Position(s) available:
Spring (Jan. – May)
Summer (June – Aug.)
Starting Date:
Pay (if any):
Benefits (if any):
Required Majors:
Required Skills:
Required Certifications:
Special Application Instructions:
Other
Position Description (Please be as detailed as possible)
Request for assignment of a co-op/intern in the described position is approved and will not result in
the displacement of a regular employee or impair existing contracts for services.
Company Representative
Title
PLEASE RETURN TO:
Richard P. Mikat, Ph.D., FACSM
ESS-Exercise Science Program Director
129 Mitchell Hall
University of Wisconsin-La Crosse
1725 State Street
La Crosse, WI 54601
Fax: (608) 785-8172
E-mail: mikat.rich@uwlax.edu (attachments must include signatures)
Date