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Text Item Type Metadata
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Ben™s = Ss
at a ge ee Pay See a. a. a ~ TS i a a lS To eS
\y . -
y 30 Courtland Street, N.E.
ATLANTA URBAN CORPS INE RS Reo ON RENT Atlanta, Georgia 30303
INTERN NO. 1 | COLLEGE 2) DATE 3
if ae Ratios College | ieee a. abe
; a E
se [© Manney Berk
ADDRESS Yollow Springs, Ohio 45387
FART TIME
, ; INITIAL ASSIGNMENT
~ ie AAntioch Union REASSIGNMENT
*.
™ SUMMER
& Ez
[es a Ble Cle Cp
AGENCY 7 | COORDINATOR 8 | PHONE * io,
d City of Atlanta mA Dan E. Seeat, Jr. i 522-4463 Ext. 280 2
san t re | | ; nse NATURE OF ASSIGNMENT fi
=a boil | {ines eat a Guemer Program Evaluation Intern
209 City Hall To monitor -sumer program components and recommend changes
ellie Georgia 30303 as needed. Also to assist in the compilation of summer
facte for final report and evaluation, Will require field
work as well ap-ineide desk work.
SOR SUPERVISOR'S PHONE
ad
ACCEPTED
[__]eecuineo
UNACCEPTABLE
S WEAT
ALL
3 eTaAVd
ASSIGNMENT AME OF CENTER
CITY
ASSIGNMENT ADDRESS
17] ASSIGNMENT HOURS.
MON
TUES
6
WED
THURS
|FoLo
FRI
SAT
ete) |
SUN
(ial | decline this assignment and wish to be reassigned because:
ea] | wish to withdraw “an the. URBAN CORPS. (see item 5 on reverse) les
DISTRIBUTION: WHITE,CANARY & GREEN - URBAN CORPS
PINK - AGENCY COORDINATOR AGENCY COORDINATOR
BLUE - INTERNS RECORD :
FORM UC-4 9/67 M-822278
ales at he he a il St, ad pile
INSTRUCTIONS:
TO URBAN CORPS INTERN:
lle
This is your intern assignment. In accordance with your stated preference,
you have been assigned to the position described in Box 11 on reverse
side.
You MUST contact the COORDINATOR named in Box 8 immediately to ar-
range for an interview, at which time the exact nature of your assignment
will be outlined.
Bring all five copies of this form with you to the interview. DO NOT SEP-
ARATE THEM. At your interview, the agency coordinator will fill out
Boxes 13 through 21.
The agency coordinator will retain the pink copy. You will remove the blue
copy for your records. You MUST return the other three copies to THE
ATLANTA URBAN CORPS, 30 Courtland Street, N.E., Atlanta, Ga. 30303.
IMPORTANT--NO PAYROLL WILL BE PROCESSED UNTIL THESE
FORMSARE RECEIVED BY THE URBAN CORPS OFFICE.
lf, before the interview, you decide that you do not want this assignment,
check space in Box 22 and state your reasons.
If you wish to withdraw from the URBAN CORPS, check the space in Box
23. THEN RETURN ALL COPIES TO THE URBAN CORPS.
TO AGENCY COORDINATOR:
1.
The intern who brings this form has been assigned to the specific position
whose Assignment number appears in Box 10.
2. If you accept the intern for the assigned position, complete Boxes 13
through 21.
Retain the PINK copy for your records.
RETURN THE REMAINING FOUR COPIES TO THE INTERN.
If the intern is not acceptable or declines the position, check the appro-
priate space in Box 13 and return all five copies of the form to the intern.
NOTE:
If there are any questions regarding placement procedure, please feel
free to call the URBAN CORPS at 524-8091 or write:
ATLANTA URBAN CORPS
30 Courtland Street, N.E.
Atlanta, Georgia 30303
at a ge ee Pay See a. a. a ~ TS i a a lS To eS
\y . -
y 30 Courtland Street, N.E.
ATLANTA URBAN CORPS INE RS Reo ON RENT Atlanta, Georgia 30303
INTERN NO. 1 | COLLEGE 2) DATE 3
if ae Ratios College | ieee a. abe
; a E
se [© Manney Berk
ADDRESS Yollow Springs, Ohio 45387
FART TIME
, ; INITIAL ASSIGNMENT
~ ie AAntioch Union REASSIGNMENT
*.
™ SUMMER
& Ez
[es a Ble Cle Cp
AGENCY 7 | COORDINATOR 8 | PHONE * io,
d City of Atlanta mA Dan E. Seeat, Jr. i 522-4463 Ext. 280 2
san t re | | ; nse NATURE OF ASSIGNMENT fi
=a boil | {ines eat a Guemer Program Evaluation Intern
209 City Hall To monitor -sumer program components and recommend changes
ellie Georgia 30303 as needed. Also to assist in the compilation of summer
facte for final report and evaluation, Will require field
work as well ap-ineide desk work.
SOR SUPERVISOR'S PHONE
ad
ACCEPTED
[__]eecuineo
UNACCEPTABLE
S WEAT
ALL
3 eTaAVd
ASSIGNMENT AME OF CENTER
CITY
ASSIGNMENT ADDRESS
17] ASSIGNMENT HOURS.
MON
TUES
6
WED
THURS
|FoLo
FRI
SAT
ete) |
SUN
(ial | decline this assignment and wish to be reassigned because:
ea] | wish to withdraw “an the. URBAN CORPS. (see item 5 on reverse) les
DISTRIBUTION: WHITE,CANARY & GREEN - URBAN CORPS
PINK - AGENCY COORDINATOR AGENCY COORDINATOR
BLUE - INTERNS RECORD :
FORM UC-4 9/67 M-822278
ales at he he a il St, ad pile
INSTRUCTIONS:
TO URBAN CORPS INTERN:
lle
This is your intern assignment. In accordance with your stated preference,
you have been assigned to the position described in Box 11 on reverse
side.
You MUST contact the COORDINATOR named in Box 8 immediately to ar-
range for an interview, at which time the exact nature of your assignment
will be outlined.
Bring all five copies of this form with you to the interview. DO NOT SEP-
ARATE THEM. At your interview, the agency coordinator will fill out
Boxes 13 through 21.
The agency coordinator will retain the pink copy. You will remove the blue
copy for your records. You MUST return the other three copies to THE
ATLANTA URBAN CORPS, 30 Courtland Street, N.E., Atlanta, Ga. 30303.
IMPORTANT--NO PAYROLL WILL BE PROCESSED UNTIL THESE
FORMSARE RECEIVED BY THE URBAN CORPS OFFICE.
lf, before the interview, you decide that you do not want this assignment,
check space in Box 22 and state your reasons.
If you wish to withdraw from the URBAN CORPS, check the space in Box
23. THEN RETURN ALL COPIES TO THE URBAN CORPS.
TO AGENCY COORDINATOR:
1.
The intern who brings this form has been assigned to the specific position
whose Assignment number appears in Box 10.
2. If you accept the intern for the assigned position, complete Boxes 13
through 21.
Retain the PINK copy for your records.
RETURN THE REMAINING FOUR COPIES TO THE INTERN.
If the intern is not acceptable or declines the position, check the appro-
priate space in Box 13 and return all five copies of the form to the intern.
NOTE:
If there are any questions regarding placement procedure, please feel
free to call the URBAN CORPS at 524-8091 or write:
ATLANTA URBAN CORPS
30 Courtland Street, N.E.
Atlanta, Georgia 30303