Thank you for your interest in hosting a University of Virginia student for the Career IDEAs Externship Program! Please complete the form below to be added to our mailing list of potential hosts. Externship Host Information Host Name * Job Title * Email * How are you affiliated with the University of Virginia? * Alumnus/a Parent Faculty/Staff Other Other UVA Degree(s) received UVA Graduation Year(s) Employer Company or Organization * Website * Work Phone Number * Work Address Street Address * Address Line 2 City * State * Zip * Externship Host Interest When would you like to host an extern? * Winter 2018: Jan 3 - Jan 12 Summer 2018: May 28 - Aug 24 Please list the dates you would be willing to host an extern. * How many externs are you willing to host? * - Select -12345+ What may an extern experience while shadowing you? * Special Requirements List any special requirements such as a background check, liability form, etc.