Internship Application
Internship Application
com
Applicant Information
Full Name:
Last First M.I. Apartment/Unit # State ZIP Code
Date:
Address:
Street Address City
Phone:
E-mail Address:
Fall Winter/Spring Desired Summer Internship: Social Security No.: Project Management HR/Workforce Development Communications Web Design/Dev. Brand Management Please check one: Local Internship OR Virtual Internship
YES NO
Education
High School: From: College: From: Other: From: To: To: To: Address:
YES NO
Degree:
Degree:
Degree:
References Please list two professional and/or academic references. You may attach additional references if you prefer.
Full Name: Company/ School: Address: Full Name: Company/ School: Address: Position: Phone: ( ) Position: Phone: ( )
May we contact your previous supervisor for a reference? Company: Address: Job Title: Responsibilities: From: To: Reason for Leaving:
YES NO
Ending Salary:
May we contact your previous supervisor for a reference? Company: Address: Job Title: Responsibilities: From: To: Reason for Leaving:
YES NO
Ending Salary:
Military Service
Branch: Rank at Discharge: If other than honorable, explain: From: Type of Discharge: To:
Disclaimer and Signature I certify that my answers are true and complete to the best of my knowledge. If this application leads to placement in an internship position, I understand that false or misleading information in my application or interview may result in my release from the program.
Signature: Date: *Please attach a recent copy of your resume and a cover letter. Incomplete application packets will not be considered.