Psychology 195B – New Site Application for Supervisors Form

To recruit undergraduate students for your paid or unpaid internship, please complete and submit the form below. The program’s Academic Coordinator will review your submission, and you will be notified of the decision via the email address provided.

You may indicate on the form if you would like your internship to be publicly posted on the Approved Psychology Internship Positions page. Please note that the listing will be posted exactly as submitted.

Please review the Psychology 195B: Fieldwork in Cognitive Science page for submission deadlines, internship guidelines, and supervisor responsibilities before filling out the form.

"*" indicates required fields

Company Name*

Supervisor Contact*

Email*

Address*

Phone*

Website*

Description of Organization and Population Served*

Description of Fieldwork Project and Responsibilities of Intern*

Special Qualifications*

How does this relate to Cognitive Science?*

Please let us know if you would like this internship publicly posted to the Psychology website. If not, and you are submitting this opportunity only for a specific student, please specify student’s name and which quarter they will be working in your organization. Please also let us know why you don’t want to post this opportunity.*

Hourly Commitment Per Week*