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Agency Acceptance of Student (For PEP 495 Internship) Form
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This agency hereby accepts the following student as an internship student trainee for the time and under
the specifications listed below: |
| Name of Student: |
| Starting Date: |
| Termination Date: |
| General Description of Assignment: |
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| Date: |
Student: |
| Date: |
University Supervisor: |
| Date: |
Worksite Supervisor: |
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