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Career Resource Network Form

* Fields marked with an asterisk are required.
School Information
Name *
Alum
Parent of an MPH student
Nickname
Maiden Name
Spouse's Name
School
(if alum)		 MPH
PH
Manlius
Year Graduated
(if alum)
Year Entered
(if alum)
Year Left
(if alum)
Home Information
Home Address
Home Phone
E-mail Address
College Information
College Name
Years Attended
Major
Degree
College Address/Phone
(if still attending)
Business Information
Organization Name
Business Address
Position/Title
Business Phone
Business Fax
Industry Type
Other Industry
(not specified above)
Please Choose Yes or No
Would you be willing to share information about your business and career choices with members of the MPH student body and with other MPH alumni? * yes
no
Would you be willing to participate in job shadowing, a program that involves a student or alum observing a typical day in your workplace? * yes
no
Would you be willing to provide a part time job during the summer or academic year to an MPH student or alum? * yes
no
Would you be willing to provide internships (paid or unpaid) to an MPH student or alum for a summer or an academic year? * yes
no
If you answered yes to any of the above questions, please answer the following:
What are some of the anticipated projects or responsibilities that an internship/part-time position would require with your company?
Please describe the skills necessary for a part time internship position with your company.
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