Name of Organization:
Street Address:
City State Zip
Phone Number: Fax Number:
Web Site URL:
Contact Person: Title:
E-mail Address:

Brief Description of the Organization:
 

Position Title:

Description of position (scope of responsibilities, projects in which the student would be involved):
 

Skills/Background required or desirable:
 

Wage: $

Number of Hours:

Distance From Campus (approximate):

Application Process:
 

Application deadline:

If you have any questions about filling out this form, please call the Student Engagement Center at 509-527-5183 or email us.