Intern Application

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Name of College or University

Name of Instructor

Instructor Phone/Email Information

Course Name or Academic Major

Are you requesting that your college grant credit hours for your internship?

Yes
No

Are you available for an unpaid internship?

Yes
No

Availability

Please indicate how many hours are required, the duration and dates you are available for an internship:

What days and times are you available?

Interests

Please indicate which internship you are applying for:*

Opportunity Council staff contact (if known):

Internship Experience

What motivated you to approach the Opportunity Council for an internship?

Please respond to the following statement: During an Internship with the Opportunity council I would like to work with and learn -----

Special Skills or Qualifications

Summarize related special skills and qualifications you have acquired from current or past employment, volunteer work, internship(s), education, and/or through other activities. Please be sure to list the name of the organization and contact information where the skill or qualification was gained.

Include Your Resume. (optional)

Accepted file types: pdf, doc, , Max. file size: 25 MB.

Application Agreement

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, andy false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

I agree to the terms outlined above.