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Student's Name:
WWU ID:
Student's E-Mail Address:
Quarter / Year of Registration of PLSC444:
Number of Credits:
Agency:
Office Address:
Supervisor's Name:
Supervisor's Title:
Supervisor's Address:
Supervisor's E-Mail Address:
Supervisor's Phone:
Intern's Work Phone:
Duration (no. of weeks) of the internship:
Working hours of the internship:
Description of expected assignments/duties:
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