Student Internship Application

Fri, 01/20/2012 - 1:29am — admin

Please fill out the entire form and press Submit.

Application Date: *

Student Information

Student Name: *

Age as of June 1, 2012: *

Home Phone:

Cell Phone:

Best Contact Number:

Cell

Home

Email Address: *

Parent or Guardian

Name: *

Relationship: *

Street Address: *

City, State, Zip: *

Best Contact Number: *

Email Address: *

Can Student participate in an internship assignment for 5 Consecutive weeks during summer 2012?:

Yes

If no, what dates would the student be able to participate?:

Transportation Information

How will student be transported to & from Internship? (Parents, Own Car, Public Transportation):

Maximum Driving Distance (Miles):

School Information

School Name: *

County: *

Type of School (Private, Public, Magnet, Charter, etc...): *

Current Education

Current Grade: *

Current GPA:

Science courses taken:

Technology courses taken:

Engineering courses taken:

Mathematics courses taken:

School Internship Coordinator / College or Guidance Counselor

Name:

Position:

Business Phone:

Cell Phone:

Email Address:

Interests

How do you intend to use your experience in these areas to further your professional goals?:

Describe the top THREE qualities you possess that will make you a valuable intern:

Why did you choose these qualities?:

What are your career aspirations?:

What are your education aspirations?:

Briefly describe any work experiences you have had. If you have had multiple work experiences, describe the one that you gained :

What is your proudest achievement?:

Describe your ideal internship!:

In 10 words or less, Why do you want this internship?:

How did you learn about this opportunity?:

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