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Lower Merion Conservancy Internship Application
Date: ________________
Applicant:
Name______________________________________________
School_____________________________________________
Degree/Major_______________________________________
Expected Graduation Date____________________________
Proposed Weekly Hours______________________________
Phone Number______________________________________
E-mail address______________________________________
Address____________________________________________
___________________________________________________
___________________________________________________
Faculty contact/advisor:
Name______________________________________________
Phone Number______________________________________
E-mail address______________________________________
Address____________________________________________
___________________________________________________
___________________________________________________
Summary of proposed project:
____________________________________________________
____________________________________________________
____________________________________________________
Signature____________________________________________
Date________________________________________________
If under 18 year old, signature of Parent or Guardian
_____________________________________________________
Date_________________________________________________
Updated: 1/9/2004 © 2010Lower Merion Conservancy. All rights reserved.
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