PLACEMENT SITE - INTERNSHIP REQUEST
Dear Placement Site Manager:
Thank you for your desire to establish a Polk State College student internship at your organization. Please provide the information below to
enable us to successfully assist you.
If you have any questions regarding this form, establishing an internship, or about Polk State College, please contact the Internship
Coordinator, at internships@polk.edu or 863.298.6897. For more information about Polk State College or our degree programs, please
visit our website at polk.edu. We look forward to assisting you with a Polk State intern!
Please list below the specific duties and/or projects to be assigned to the intern:
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Semester/schedule (days/hours) of internship anticipated:
Is there any other information you would like us to know before we schedule student(s) to interview with you for this internship?
Thank you for your support of Polk State!
Polk State College is committed to equal access/equal opportunity in its programs,
activities, and employment. For additional information, visit polk.edu/equity.