Work Verification Form

For work completed during the period of August 2016 through August 2023. You need one submission for every internship during this time frame.

Student Work Verification Form

1. Name (Please provide your first, middle and last name.)

4. Work Period Included in this Form

Please provide the month of your start and end dates. NOTE: One internship and one company per form. If you worked for two companies, each for five weeks over the period of one summer - you need two forms.

Must be an @purdue email address.
Select all that apply.
Examples: updating employee records, sales, supply chain analysis, onboarding activities, daily reports, assisted in interviewing, etc...

Company Information

Please use the address of the office that you worked in or that your jobsite/project reported to.
You must enter a valid e mail address and phone number in order to record and verify your hours. Please take the time to find and then confirm a correct email for your supervisor.