Internship Application

Your Contact Information

First Name *

Last Name *

Email *

Address Line 1 *

Address Line 2

Phone

City *

State *

Zip *

Emergency Contact *

Emergency Contact Phone *

Emergency Contact Email

Which Position are you applying for? * The field Which Position are you applying for? is required.

Which semester and year? * The field Which semester and year? is required.

How many Hours do you require? * The field How many Hours do you require? is required.

If offered the internship, when could you start? * The date field If offered the internship, when could you start? is required.

What are you hoping to gain from this experience? * The field What are you hoping to gain from this experience? is required.

List skills you would you like to use while here: * The field List skills you would you like to use while here: is required.

If offered the internship, when must it end? The field If offered the internship, when must it end? must be a date.

How did you hear about House of Hope? * The field How did you hear about House of Hope? is required.

Please list your availibility during the following times

Monday 8am - 4pm The maximum length for the field Monday 8am - 4pm is 500 characters.

Tuesday 8am - 4pm The maximum length for the field Tuesday 8am - 4pm is 500 characters.

Wednesday 8am-630pm The maximum length for the field Wednesday 8am-630pm is 500 characters.

Thursday 8am - 4pm The maximum length for the field Thursday 8am - 4pm is 500 characters.

Friday 8am - 4pm The maximum length for the field Friday 8am - 4pm is 500 characters.

Up to One Saturday per month The maximum length for the field Up to One Saturday per month is 500 characters.

Please list three references. Include Name, Phone Number, E-mail address, Length of time known, and Relationship.

Reference 1 The maximum length for the field Reference 1 is 5000 characters.

Reference 2 The maximum length for the field Reference 2 is 5000 characters.

Reference 3 The maximum length for the field Reference 3 is 5000 characters.

Typing your NAME and DATE signifies you are completing this form using an electronic signature.

Signing electronically, confirms that the above information is accurate.

Electronic Signature (Type Name here): * The field Electronic Signature (Type Name here): is required.

Date Signed * The date field Date Signed is required.