MGT 498C Profile Form (submit at first class meeting)

Your Name: Course Ticket No.

Student ID: CSUN User ID:

e-mail (please write very clearly)

Daytime Phone Evening Phone

Current Job / Desired Career Total no. of years work experience:________

Most important goals for the next 10 years

Hobbies / Interests

3 Things you wish others knew about you

Internship Sponsor (organization): Name and location/mailing address

Name: Location:

Mailing Address:

Internship Supervisor (your ‘boss’ in the organization):

Name: Title:

Internship Supervisor’s phone, fax & email address (if available)

Phone: Fax:

Email address:

How does your supervisor wish to receive the supervisor survey?

( ____ email ) ( ____ fax ) ( ____Mail )