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Internship Application Form

Note: You will need to upload a copy of your resume and transcript (official or unofficial) after filling out the information below.

A. Personal Information

First Name*:

Last Name*:

Social Security #:

Date of Birth:

Do you have a valid driver's license? Yes No

License Number:

State:

Exp. Date:

Has your license ever been suspended or revoked? Yes No

If yes, please explain:

Permanent Address

Street:

City:

State:

Zip:

Phone:

E-Mail:

Current/School Address

check box if same as above

Street:

City:

State:

Zip:

Phone:

E-Mail:

B. Education Information

College/Univer.*:

Degree*:

Major*:

Expected
Grad. Date*:

Cumulative GPA (n.nn/4.00)*:

List Relevant Coursework:

C. References

Reference 1

First Name:

Last Name:

Relationship:

Phone:

Email:

Reference 2

First Name:

Last Name:

Relationship:

Phone:

Email:

Reference 3

First Name:

Last Name:

Relationship:

Phone:

Email:

D. Internship Project Preferences

Please list your top three internship choices.

Choice 1*:

Choice 2*:

Choice 3*:

E. Discussion Questions

Please respond to the following questions, limiting your responses to 200 words or less.

Describe a time when you worked on a group project. What was your role? How did you contribute?

Discuss a situation in which you had to adjust to changes over which you had no control and how you handled it.

Describe a time when you had to sell an idea to someone. How did you do it? What was the outcome?

Discuss an important decision you made regarding a project or assignment. What factors influenced your decision?