435 WEST 116TH STREET, BOX B-26, NEW YORK, NY 10027
Guaranteed Summer Funding/ Human Rights Internship Program
Employment Verification Form 2013
Student Name: _____________________________________
Organization: _____________________________________
Supervisor:
_____________________________________
Period of Employment: ______________________________
This form certifies that ________________ worked for __________________, full-time
(student name)
(organization name)
from_________________under the direct supervision of ______________________ .
(dates of employment)
(supervisor name)
Mr./Mrs./Ms.________________certifies that __________________successfully and
(supervisor name)
(student name)
fully completed the terms of his/her internship with ______________________.
(organization name)
Supervisor Signature:______________________________________
Date: _____________________________________________________
410 West 116th Street, 3rd floor, New York, NY 10027
summerfunding@law.columbia.edu, 212.854.6158, 212.854.3515 (fax)