{"id":1995,"date":"2023-09-12T10:37:16","date_gmt":"2023-09-12T14:37:16","guid":{"rendered":"https:\/\/www.gcc.mass.edu\/registrar\/?page_id=1995"},"modified":"2026-09-08T13:22:31","modified_gmt":"2026-09-08T17:22:31","slug":"internships","status":"publish","type":"page","link":"https:\/\/www.gcc.mass.edu\/registrar\/forms\/internships\/","title":{"rendered":"Internship Proposal\/Application"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_35' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_35'  action='\/registrar\/wp-json\/wp\/v2\/pages\/1995#gf_35' data-formid='35' novalidate><input type=\"hidden\" value=\"0\" name=\"gpps_page_progression_35\" \/>\n        <div id='gf_progressbar_wrapper_35' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>2<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_50' style='width:50%;'><span>50%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_35_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_35' class='gform_fields top_label form_sublabel_below description_above validation_below' data-column-layout='fill'><div id=\"field_35_60\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"d87515fc\" data-field-span=\"12\"><h3 class=\"gsection_title\">Admin Only<\/h3><\/div><div id=\"field_35_47\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"ba032e88\" data-field-span=\"6\"><label id='gfield_label_35_47' class='gfield_label gform-field-label' for='input_35_47'><span class='gform-field-label__text'>CRN<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_35_47' type='text' value='' class='large'   tabindex='1000'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_35_63\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e7c42982\" data-field-span=\"4\"><label id='gfield_label_35_63' class='gfield_label gform-field-label' for='input_35_63'><span class='gform-field-label__text'>Amount<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_35_63' type='text' value='' class='large'   tabindex='1001'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_35_65\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e7b3e06d\" data-field-span=\"12\"><label id='gfield_label_35_65' class='gfield_label gform-field-label' for='input_35_65'><span class='gform-field-label__text'>Fund #<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_65' id='input_35_65' type='text' value='' class='large'   tabindex='1002'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_35_61\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"8d3eb650\" data-field-span=\"12\"><h3 class=\"gsection_title\">Application<\/h3><\/div><fieldset id=\"field_35_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2760b52e\" data-field-span=\"6\"><legend id='gfield_label_35_1' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_35_1'>\n                            \n                            <span id='input_35_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_35_1_3' value='' tabindex='1004'  aria-required='true'     aria-labelledby=\"input_35_1_3_label gfield_label_35_1\"\/>\n                                                    <label for='input_35_1_3' id='input_35_1_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_35_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_35_1_6' value='' tabindex='1006'  aria-required='true'     \/>\n                                                    <label for='input_35_1_6' id='input_35_1_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_35_3\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2760b52e\" data-field-span=\"6\"><legend id='gfield_label_35_3' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_35_3_container'>\n                                <span id='input_35_3_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_3' id='input_35_3' value='' tabindex='1008'   aria-required=\"true\" aria-invalid=\"false\"  aria-labelledby=\"input_35_3_label gfield_label_35_3\" \/>\n                                    <label for='input_35_3' id='input_35_3_label' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_35_3_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_3_2' id='input_35_3_2' value='' tabindex='1009'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_35_3_2' id='input_35_3_2_label' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_35_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"cd78bc15\" data-field-span=\"4\"><label id='gfield_label_35_4' class='gfield_label gform-field-label' for='input_35_4'><span class='gform-field-label__text'>Student ID #<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_35_4' type='text' value='' class='large'   tabindex='1010'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_35_59\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"cd78bc15\" data-field-span=\"4\"><label id='gfield_label_35_59' class='gfield_label gform-field-label' for='input_35_59'><span class='gform-field-label__text'>Major<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_59' id='input_35_59' class='large gfield_select' tabindex='1011'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' >Please choose<\/option><option value='Addiction Studies Certificate (ASC) CERT' >Addiction Studies Certificate (ASC) CERT<\/option><option value='Adventure Education (ADE) AS' >Adventure Education (ADE) AS<\/option><option value='Allied Health (ALH) AS' >Allied Health (ALH) AS<\/option><option value='Allied Health\/Dental Assisting Intent (ALH) AS' >Allied Health\/Dental Assisting Intent (ALH) AS<\/option><option value='Allied Health\/Kinesiology Transfer Intent (ALH) AS' >Allied Health\/Kinesiology Transfer Intent (ALH) AS<\/option><option value='Allied Health\/LPN Intent (ALH) AS' >Allied Health\/LPN Intent (ALH) AS<\/option><option value='Allied Health\/Nutrition Transfer Intent (ALH) AS' >Allied Health\/Nutrition Transfer Intent (ALH) AS<\/option><option value='Allied Health\/PMC Intent (ALH) AS' >Allied Health\/PMC Intent (ALH) AS<\/option><option value='Allied Health\/Physical Therapy Assistant Intent (ALH) AS' >Allied Health\/Physical Therapy Assistant Intent (ALH) AS<\/option><option value='Allied Health\/Public Health Transfer Intent (ALH) AS' >Allied Health\/Public Health Transfer Intent (ALH) AS<\/option><option value='Allied Health\/Radiologic Technology Intent (ALH) AS' >Allied Health\/Radiologic Technology Intent (ALH) AS<\/option><option value='Allied Health\/Respiratory Therapy Intent (ALH) AS' >Allied Health\/Respiratory Therapy Intent (ALH) AS<\/option><option value='Allied Health\/RN Intent (ALH) AS' >Allied Health\/RN Intent (ALH) AS<\/option><option value='Allied Health\/SGT (ALH) AS' >Allied Health\/SGT (ALH) AS<\/option><option value='Art\/Visual Art Transfer Block (AVC) AS' >Art\/Visual Art Transfer Block (AVC) AS<\/option><option value='Art\/Visual Arts (AVA) AS' >Art\/Visual Arts (AVA) AS<\/option><option value='Biology (BIO) AS' >Biology (BIO) AS<\/option><option value='Business Administration General (BAG) AS' >Business Administration General (BAG) AS<\/option><option value='Business Administration Transfer (BAT) AA' >Business Administration Transfer (BAT) AA<\/option><option value='Chemistry (CHE) AS' >Chemistry (CHE) AS<\/option><option value='Computer Science (CSC) AS' >Computer Science (CSC) AS<\/option><option value='Early Childhood Education (ECE) AS' >Early Childhood Education (ECE) AS<\/option><option value='Early Childhood Education Certificate (CECE) CERT' >Early Childhood Education Certificate (CECE) CERT<\/option><option value='Engineering Science (EGS) AS' >Engineering Science (EGS) AS<\/option><option value='Environmental Conservation (ENC) AS' >Environmental Conservation (ENC) AS<\/option><option value='Farm and Food Systems (LFF) AA' >Farm and Food Systems (LFF) AA<\/option><option value='Fire Science Technology (FST) AS' >Fire Science Technology (FST) AS<\/option><option value='Human Services (HSE) AS' >Human Services (HSE) AS<\/option><option value='Justice Studies (JUS) AS' >Justice Studies (JUS) AS<\/option><option value='Liberal Arts (LIB) AA' >Liberal Arts (LIB) AA<\/option><option value='Liberal Arts\/Contemporary Music Studies (LCMS) AA' >Liberal Arts\/Contemporary Music Studies (LCMS) AA<\/option><option value='Liberal Arts\/Education (LEO) AA' >Liberal Arts\/Education (LEO) AA<\/option><option value='Liberal Arts\/English (LAE) AA' >Liberal Arts\/English (LAE) AA<\/option><option value='Liberal Arts\/Farm and Food Systems (LFF) AA' >Liberal Arts\/Farm and Food Systems (LFF) AA<\/option><option value='Liberal Arts\/History (LHI) AA' >Liberal Arts\/History (LHI) AA<\/option><option value='Liberal Arts\/Mathematics (LMA) AA' >Liberal Arts\/Mathematics (LMA) AA<\/option><option value='Liberal Arts\/Social Sciences (LSS) AA' >Liberal Arts\/Social Sciences (LSS) AA<\/option><option value='Liberal Arts\/Theater (LAT) AA' >Liberal Arts\/Theater (LAT) AA<\/option><option value='Management Certificate (MGT) CERT' >Management Certificate (MGT) CERT<\/option><option value='Medical Assistant Certificate (MAC) CERT' >Medical Assistant Certificate (MAC) CERT<\/option><option value='Music Recording and Production Certificate (MRP) CERT' >Music Recording and Production Certificate (MRP) CERT<\/option><option value='Outdoor Leadership Certificate (OLP) CERT' >Outdoor Leadership Certificate (OLP) CERT<\/option><option value='Plant &amp; Soil Science (PSS) AS' >Plant &amp; Soil Science (PSS) AS<\/option><option value='Pre-Nursing (NUC) CERT' >Pre-Nursing (NUC) CERT<\/option><option value='Pre-Nursing\/ADN Intent (NUC) CERT' >Pre-Nursing\/ADN Intent (NUC) CERT<\/option><option value='Pre-Nursing\/LPN Intent (NUC) CERT' >Pre-Nursing\/LPN Intent (NUC) CERT<\/option><option value='Pre-Nursing\/Nursing Bridge Intent (NUC) CERT ** ONLY AVAILABLE FOR PRACTICAL NURSES **' >Pre-Nursing\/Nursing Bridge Intent (NUC) CERT ** ONLY AVAILABLE FOR PRACTICAL NURSES **<\/option><option value='Visual Arts Certificate (VAC) CERT' >Visual Arts Certificate (VAC) CERT<\/option><option value='Web Development &amp; Design Certificate (WDD) CERT' >Web Development &amp; Design Certificate (WDD) CERT<\/option><option value='World Language in French (WFR) CERT' >World Language in French (WFR) CERT<\/option><option value='World Language in Spanish (WSP) CERT' >World Language in Spanish (WSP) CERT<\/option><\/select><\/div><\/div><div id=\"field_35_9\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"cd78bc15\" data-field-span=\"4\"><label id='gfield_label_35_9' class='gfield_label gform-field-label' for='input_35_9'><span class='gform-field-label__text'>Phone<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_9' id='input_35_9' type='tel' value='' class='large' tabindex='1012' placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><fieldset id=\"field_35_40\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gf_list_inline gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"7f29e0ee\" data-field-span=\"12\"><legend id='gfield_label_35_40' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Age<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_35_40'>\n\t\t\t<div class='gchoice gchoice_35_40_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Under 18'  id='choice_35_40_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_35_40_0 gfield_label_35_40\" tabindex='1013'  \/>\n\t\t\t\t\t<label for='choice_35_40_0' id='label_35_40_0' class='gform-field-label gform-field-label--type-inline'>Under 18<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_35_40_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Over 18'  id='choice_35_40_1' onchange='gformToggleRadioOther( this )'   tabindex='1014'  \/>\n\t\t\t\t\t<label for='choice_35_40_1' id='label_35_40_1' class='gform-field-label gform-field-label--type-inline'>Over 18<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_35_41\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"13318334\" data-field-span=\"6\"><legend id='gfield_label_35_41' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Parent\/Guardian Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_35_41'>\n                            \n                            <span id='input_35_41_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_41.3' id='input_35_41_3' value='' tabindex='1016'  aria-required='true'     aria-labelledby=\"input_35_41_3_label gfield_label_35_41\"\/>\n                                                    <label for='input_35_41_3' id='input_35_41_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_35_41_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_41.6' id='input_35_41_6' value='' tabindex='1018'  aria-required='true'     \/>\n                                                    <label for='input_35_41_6' id='input_35_41_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_35_42\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"13318334\" data-field-span=\"6\"><legend id='gfield_label_35_42' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Parent\/Guardian Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_35_42_container'>\n                                <span id='input_35_42_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_42' id='input_35_42' value='' tabindex='1020'   aria-required=\"true\" aria-invalid=\"false\"  aria-labelledby=\"input_35_42_label gfield_label_35_42\" \/>\n                                    <label for='input_35_42' id='input_35_42_label' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_35_42_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_42_2' id='input_35_42_2' value='' tabindex='1021'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_35_42_2' id='input_35_42_2_label' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_35_20\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1987cf03\" data-field-span=\"12\"><div class=\"callout\"><i class=\"fas fa-circle-info\" aria-hidden=\"true\"><\/i><div class=\"callout-content\"><p>A 294-level internship indicates you have <em>already<\/em> completed a 293-level internship in the same field of study. E.g., after completing BIO 293 Internship in Biology you would then take BIO 294 Internship in Biology. Refer to the <a href=\"\/internships\/overview\/\" target=\"_blank\">internship website<\/a> for more information.<\/p> <\/div><\/div><\/div><div id=\"field_35_6\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"fcb32947\" data-field-span=\"6\"><label id='gfield_label_35_6' class='gfield_label gform-field-label' for='input_35_6'><span class='gform-field-label__text'>Course Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_6' id='input_35_6' class='large gfield_select' tabindex='1022'   aria-required=\"true\" aria-invalid=\"false\" ><option value='293 - Internship I' selected='selected'>293 - Internship I<\/option><option value='294 - Internship II' >294 - Internship II<\/option><\/select><\/div><\/div><div id=\"field_35_7\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"fcb32947\" data-field-span=\"6\"><label id='gfield_label_35_7' class='gfield_label gform-field-label' for='input_35_7'><span class='gform-field-label__text'>Subject<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_7' id='input_35_7' class='large gfield_select' tabindex='1023'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' >Please Choose<\/option><option value='ACC' >ACC<\/option><option value='ACS' >ACS<\/option><option value='AGR' >AGR<\/option><option value='AHS' >AHS<\/option><option value='ANT' >ANT<\/option><option value='ART' >ART<\/option><option value='ASL' >ASL<\/option><option value='BIO' >BIO<\/option><option value='BUS' >BUS<\/option><option value='CHE' >CHE<\/option><option value='CIS' >CIS<\/option><option value='CMN' >CMN<\/option><option value='CRJ' >CRJ<\/option><option value='CSC' >CSC<\/option><option value='ECO' >ECO<\/option><option value='EDU' >EDU<\/option><option value='EGR' >EGR<\/option><option value='EGT' >EGT<\/option><option value='ENG' >ENG<\/option><option value='EVS' >EVS<\/option><option value='FRE' >FRE<\/option><option value='GEO' >GEO<\/option><option value='GWS' >GWS<\/option><option value='HIS' >HIS<\/option><option value='HSV' >HSV<\/option><option value='HUD' >HUD<\/option><option value='HUM' >HUM<\/option><option value='JUS' >JUS<\/option><option value='LAT' >LAT<\/option><option value='MAT' >MAT<\/option><option value='MOM' >MOM<\/option><option value='MUS' >MUS<\/option><option value='OLP' >OLP<\/option><option value='PCS' >PCS<\/option><option value='PHI' >PHI<\/option><option value='PHY' >PHY<\/option><option value='POL' >POL<\/option><option value='PSY' >PSY<\/option><option value='REE' >REE<\/option><option value='SCI' >SCI<\/option><option value='SGT' >SGT<\/option><option value='SOC' >SOC<\/option><option value='SPA' >SPA<\/option><option value='THE' >THE<\/option><\/select><\/div><\/div><fieldset id=\"field_35_53\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\" data-group-id=\"fb404dd5\" data-field-span=\"4\"><legend id='gfield_label_35_53' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Dean<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_35_53'>\n\t\t\t<div class='gchoice gchoice_35_53_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_53' type='radio' value='Nursing' checked='checked' id='choice_35_53_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_35_53_0 gfield_label_35_53\" tabindex='1024'  \/>\n\t\t\t\t\t<label for='choice_35_53_0' id='label_35_53_0' class='gform-field-label gform-field-label--type-inline'>Nursing<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_35_52\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\" data-group-id=\"fb404dd5\" data-field-span=\"4\"><legend id='gfield_label_35_52' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Dean<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_35_52'>\n\t\t\t<div class='gchoice gchoice_35_52_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Allied Health' checked='checked' id='choice_35_52_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_35_52_0 gfield_label_35_52\" tabindex='1025'  \/>\n\t\t\t\t\t<label for='choice_35_52_0' id='label_35_52_0' class='gform-field-label gform-field-label--type-inline'>Allied Health<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_35_54\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\" data-group-id=\"fb404dd5\" data-field-span=\"4\"><legend id='gfield_label_35_54' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Dean<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_35_54'>\n\t\t\t<div class='gchoice gchoice_35_54_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_54' type='radio' value='Liberal Arts' checked='checked' id='choice_35_54_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_35_54_0 gfield_label_35_54\" tabindex='1026'  \/>\n\t\t\t\t\t<label for='choice_35_54_0' id='label_35_54_0' class='gform-field-label gform-field-label--type-inline'>Liberal Arts<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_35_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\" data-group-id=\"39d43575\" data-field-span=\"4\"><legend id='gfield_label_35_55' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Grouping<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_35_55'>\n\t\t\t<div class='gchoice gchoice_35_55_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Melanie' checked='checked' id='choice_35_55_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_35_55_0 gfield_label_35_55\" tabindex='1027'  \/>\n\t\t\t\t\t<label for='choice_35_55_0' id='label_35_55_0' class='gform-field-label gform-field-label--type-inline'>Melanie<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_35_58\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\" data-group-id=\"39d43575\" data-field-span=\"4\"><legend id='gfield_label_35_58' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Grouping<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_35_58'>\n\t\t\t<div class='gchoice gchoice_35_58_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='Amy' checked='checked' id='choice_35_58_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_35_58_0 gfield_label_35_58\" tabindex='1028'  \/>\n\t\t\t\t\t<label for='choice_35_58_0' id='label_35_58_0' class='gform-field-label gform-field-label--type-inline'>Amy<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_35_56\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\" data-group-id=\"39d43575\" data-field-span=\"4\"><legend id='gfield_label_35_56' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Grouping<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_35_56'>\n\t\t\t<div class='gchoice gchoice_35_56_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_56' type='radio' value=''  id='choice_35_56_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_35_56_0 gfield_label_35_56\" tabindex='1029'  \/>\n\t\t\t\t\t<label for='choice_35_56_0' id='label_35_56_0' class='gform-field-label gform-field-label--type-inline'><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_35_10\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e6910c7e\" data-field-span=\"4\"><label id='gfield_label_35_10' class='gfield_label gform-field-label' for='input_35_10'><span class='gform-field-label__text'>Credits<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_10' id='input_35_10' class='large gfield_select' tabindex='1030'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' >Please Choose<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><\/select><\/div><\/div><div id=\"field_35_11\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e6910c7e\" data-field-span=\"4\"><label id='gfield_label_35_11' class='gfield_label gform-field-label' for='input_35_11'><span class='gform-field-label__text'>Term<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_11' id='input_35_11' class='large gfield_select' tabindex='1031'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' >Please Choose<\/option><option value='Spring' >Spring<\/option><option value='Summer' >Summer<\/option><option value='Fall' >Fall<\/option><\/select><\/div><\/div><div id=\"field_35_12\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e6910c7e\" data-field-span=\"4\"><label id='gfield_label_35_12' class='gfield_label gform-field-label' for='input_35_12'><span class='gform-field-label__text'>Year<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_35_12' class='large gfield_select' tabindex='1032'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' >Please Choose<\/option><option value='2026' >2026<\/option><\/select><\/div><\/div><fieldset id=\"field_35_14\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"ebffcbad\" data-field-span=\"12\"><legend id='gfield_label_35_14' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Faculty Mentor<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_35_14'>\n                            \n                            <span id='input_35_14_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_14.3' id='input_35_14_3' value='' tabindex='1034'  aria-required='true'     aria-labelledby=\"input_35_14_3_label gfield_label_35_14\"\/>\n                                                    <label for='input_35_14_3' id='input_35_14_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_35_14_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_14.6' id='input_35_14_6' value='' tabindex='1036'  aria-required='true'     \/>\n                                                    <label for='input_35_14_6' id='input_35_14_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_35_17\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"7ec53fb6\" data-field-span=\"12\"><legend id='gfield_label_35_17' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Faculty Mentor Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_35_17'><strong>Make sure to get this part right!<\/strong> Your mentor will be sent a copy of your application to approve; if their address is not accurate, they won't get the email!<\/div><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_35_17_container'>\n                                <span id='input_35_17_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_17' id='input_35_17' value='' tabindex='1038'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_35_17\" aria-labelledby=\"input_35_17_label gfield_label_35_17\" \/>\n                                    <label for='input_35_17' id='input_35_17_label' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_35_17_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_17_2' id='input_35_17_2' value='' tabindex='1039'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_35_17\" \/>\n                                    <label for='input_35_17_2' id='input_35_17_2_label' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_35_15\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2185e636\" data-field-span=\"12\"><label id='gfield_label_35_15' class='gfield_label gform-field-label' for='input_35_15'><span class='gform-field-label__text'>Internship Site<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_35_15'>Name of company\/organization & location<\/div><div class='ginput_container ginput_container_text'><input name='input_15' id='input_35_15' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_15\" tabindex='1040'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_35_16\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"0d4e31f0\" data-field-span=\"12\"><legend id='gfield_label_35_16' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Site Supervisor<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_35_16'>\n                            \n                            <span id='input_35_16_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_16.3' id='input_35_16_3' value='' tabindex='1042'  aria-required='true'     aria-labelledby=\"input_35_16_3_label gfield_label_35_16\"\/>\n                                                    <label for='input_35_16_3' id='input_35_16_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_35_16_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_16.6' id='input_35_16_6' value='' tabindex='1044'  aria-required='true'     \/>\n                                                    <label for='input_35_16_6' id='input_35_16_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_35_13\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"3be228c8\" data-field-span=\"12\"><legend id='gfield_label_35_13' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Site Supervisor Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_35_13'><strong>Make sure to get this part right!<\/strong> Your site contact will be sent a copy of your proposal to approve; if their address is not accurate, they won't get the email!<\/div><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_35_13_container'>\n                                <span id='input_35_13_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_13' id='input_35_13' value='' tabindex='1046'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_35_13\" aria-labelledby=\"input_35_13_label gfield_label_35_13\" \/>\n                                    <label for='input_35_13' id='input_35_13_label' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_35_13_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_13_2' id='input_35_13_2' value='' tabindex='1047'   aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_35_13\" \/>\n                                    <label for='input_35_13_2' id='input_35_13_2_label' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_35_32\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"0c2dd52c\" data-field-span=\"12\"><label id='gfield_label_35_32' class='gfield_label gform-field-label' for='input_35_32'><span class='gform-field-label__text'>Site Contact Phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_32' id='input_35_32' type='tel' value='' class='large' tabindex='1048' placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_35_8\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"f048fcc3\" data-field-span=\"12\"><div class=\"alert alert-info\" style=\"margin-bottom:-20px; margin-top:20px;\"><p>Complete the next section in consultation with your Faculty Mentor.<\/p> <\/div><\/div><div id=\"field_35_18\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"a05935e8\" data-field-span=\"12\"><label id='gfield_label_35_18' class='gfield_label gform-field-label' for='input_35_18'><span class='gform-field-label__text'>Field of Focus or Area of Study<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_18' id='input_35_18' class='textarea small' tabindex='1049'    aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_35_19\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"c3b2b23c\" data-field-span=\"12\"><label id='gfield_label_35_19' class='gfield_label gform-field-label' for='input_35_19'><span class='gform-field-label__text'>Mentor Meetings<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_35_19'>How often and for what purpose will you meet with or contact your Faculty Mentor?<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_19' id='input_35_19' class='textarea small' tabindex='1050' aria-describedby=\"gfield_description_35_19\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_35_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"7cbbd499\" data-field-span=\"6\"><label id='gfield_label_35_23' class='gfield_label gform-field-label' for='input_35_23'><span class='gform-field-label__text'>Length of Internship<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_35_23' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_23\" tabindex='1051'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_35_23'>Approximately how many weeks will the internship last?<\/div><\/div><div id=\"field_35_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"7cbbd499\" data-field-span=\"6\"><label id='gfield_label_35_22' class='gfield_label gform-field-label' for='input_35_22'><span class='gform-field-label__text'>Weekly Hours<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_35_22' type='text' value='' class='large'  aria-describedby=\"gfield_description_35_22\" tabindex='1052'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_35_22'>Approximately how many hours per week will you be working? List min\/max hours per week as well.<\/div><\/div><div id=\"field_35_24\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"327e37be\" data-field-span=\"6\"><label id='gfield_label_35_24' class='gfield_label gform-field-label' for='input_35_24'><span class='gform-field-label__text'>Start Date<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_35_24'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_24'\n\t\t\t\t value=''\n\t\t\t\t\taria-describedby=\"gfield_description_35_24\" \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\ttabindex='1053' \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_35_24' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_35_24' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_35_24' aria-label='Start Date: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><div class='gfield_description' id='gfield_description_35_24'>The start date of your internship can not be before the first day of classes for the term<\/div><\/div><div id=\"field_35_25\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"327e37be\" data-field-span=\"6\"><label id='gfield_label_35_25' class='gfield_label gform-field-label' for='input_35_25'><span class='gform-field-label__text'>End Date<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_35_25'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_25'\n\t\t\t\t value=''\n\t\t\t\t\taria-describedby=\"gfield_description_35_25\" \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\ttabindex='1054' \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_35_25' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_35_25' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_35_25' aria-label='End Date: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><div class='gfield_description' id='gfield_description_35_25'>The end date of your internship can not be after the last day of classes for the term\u2014however please indicate the <strong>actual end date<\/strong> if you will complete your internships prior to the end of the term<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_35_26' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' tabindex='1055'>Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_35_2' class='gform_page' data-js='page-field-id-26' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_35_2' class='gform_fields top_label form_sublabel_below description_above validation_below' data-column-layout='fill'><div id=\"field_35_27\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"a85a3510\" data-field-span=\"12\"><h3 class=\"gsection_title\">Learning Plan<\/h3><\/div><div id=\"field_35_28\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"103d87f2\" data-field-span=\"12\"><label id='gfield_label_35_28' class='gfield_label gform-field-label' for='input_35_28'><span class='gform-field-label__text'>What do you hope to gain from this internship?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_35_28'>List specific learning objectives<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_28' id='input_35_28' class='textarea medium' tabindex='1056' aria-describedby=\"gfield_description_35_28\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_35_29\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"96d97585\" data-field-span=\"12\"><label id='gfield_label_35_29' class='gfield_label gform-field-label' for='input_35_29'><span class='gform-field-label__text'>What will your internship site gain?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_35_29'>How will the organization or company benefit from your placement?<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_29' id='input_35_29' class='textarea medium' tabindex='1057' aria-describedby=\"gfield_description_35_29\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_35_30\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"acd96612\" data-field-span=\"12\"><label id='gfield_label_35_30' class='gfield_label gform-field-label' for='input_35_30'><span class='gform-field-label__text'>How will you demonstrate success in achieving these learning objectives?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_35_30'>Examples could include a daily journal of your experiences, research papers, a portfolio of creations, etc.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_30' id='input_35_30' class='textarea medium' tabindex='1058' aria-describedby=\"gfield_description_35_30\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_35_31\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"fc523d55\" data-field-span=\"12\"><legend id='gfield_label_35_31' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Acknowledgement &amp; Attestation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_35_31'><div class='gchoice gchoice_35_31_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.1' type='checkbox'  value='CORI'  id='choice_35_31_1' tabindex='1059'   aria-labelledby=\"label_35_31_1 gfield_label_35_31\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_35_31_1' id='label_35_31_1' class='gform-field-label gform-field-label--type-inline'>I understand I may be subject to and will comply with CORI requirements<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_35_31_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.2' type='checkbox'  value='Health\/Immunization'  id='choice_35_31_2' tabindex='1060'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_31_2' id='label_35_31_2' class='gform-field-label gform-field-label--type-inline'>I understand I may be required to and will submit additional health and immunization information<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_35_31_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.3' type='checkbox'  value='Title IX\/AA\/EO'  id='choice_35_31_3' tabindex='1061'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_31_3' id='label_35_31_3' class='gform-field-label gform-field-label--type-inline'>I have read and understand GCC's Title IX\/Affirmative Action policies<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_35_31_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.4' type='checkbox'  value='Attestation'  id='choice_35_31_4' tabindex='1062'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_35_31_4' id='label_35_31_4' class='gform-field-label gform-field-label--type-inline'>I attest that the information in this application is correct<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_35_33\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\" data-group-id=\"185375fc\" data-field-span=\"6\"><label id='gfield_label_35_33' class='gfield_label gform-field-label' for='input_35_33'><span class='gform-field-label__text'>Internship Coordinator<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_33' id='input_35_33' type='email' value='internships@gcc.mass.edu' class='large' tabindex='1063'    aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_35_34\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\" data-group-id=\"185375fc\" data-field-span=\"6\"><label id='gfield_label_35_34' class='gfield_label gform-field-label' for='input_35_34'><span 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