WVU CEMR Career Development:

Corporate Relations and Career Assistance Co-Op and Internship Cooperative Education (Co-Op) Coordinator

Corporate Relations and Career Assistance
College of Engineering and Mineral Resources
West Virginia University
PO Box 6101
Morgantown, WV 26506-6101
P: 304.293.4370
© 2012 West Virginia University

Enrollment Form

General Information

First Name:

Last Name:

Student ID:

Date of Birth:

Citizenship:

Major:

Class:

GPA:

Email Address:

Campus Address

Address Line 1:

Address Line 2:

City:

State:

Zip:

Phone:

Ext:

Home Address

Address Line1 :

Address Line 2:

City:

State:

Zip:

Phone:

Work Interests

Why are you interested in the Co-op Program?

When can you begin?

Where would you prefer to work?

What specific field would your prefer to work?

List any specific company you would like to work for, and for what reason.