LDCC Student Internship Follow-Up Survey

Student Name(Required)

First Last

Brock Email(Required)

Enter Email Confirm Email

Student Number(Required)

What year were you enrolled in(Required)

What term were you enrolled in(Required)

What was the site of your internship(Required)

What was the purpose/goal of your internship(Required)

What was the outcome of your internship(Required)

Field Supervisor's Name(Required)

First Last

Field Supervisor's Email(Required)

Enter Email Confirm Email

How satisfied are you with your internship experience(Required)

What did you learn from your internship(Required)

What helped you to be successful in your internship(Required)

Please list any suggestions that may have helped support you throughout your internship(Required)

Did you experience any barriers in your internship(Required)

Yes

If yes, please describe.

Do you have any other comments on your internship experience

Would you be willing to have your responses on your internship adapted into an abstract to share on the webpage(Required)

We will email you a preview before posting it on the website.

Yes

Would you like to remain anonymous on the website(Required)

Yes

Would you be willing to share your internship experience in another format such as video recording(Required)

Yes

Phone

This field is for validation purposes and should be left unchanged.

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