1. Personal Information
(Name)
(Date of birth: mm/dd/yy)
(Social Security Number)
2. Education Information
(College you are attending or most recently have attended)
(Degree sought or received)
(Major field of study)
(Minor field of study)
(GPA in major field of study)
(GPA overall)
(GPA scale) i.d., 4.0 if a perfect GPA at your school is 4.0
Year in school:
Expected graduation date:
College you will be attending in the fall (if different):
(Name of school)
Have you attended any other schools previously?
Other colleges you have attended (please leave unused fields blank):
3. Contact Information
Your current address
City
State
Zip Code +
Phone Number
E-mail address
Fax Number
Dates address is effective to (mm/dd/yy)
4. Your permanent address
Street
City
State
Zip Code +
Phone number
E-mail address
Fax number
What are the dates of your spring break? to (mm/dd/yy)
Is there a number where you can be reached during that time?
In what field(s) are you interested in obtaining an internship?
Would you like information on AmeriCorps positions following this internship?
Please list and describe any course work or special projects you have completed or are working on which are applicable to the field(s) of interest you have indicated above.
What work experience, special training or other activities have you had which would apply to the work you would do on an internship?
What special skills do you have which would contribute to an internship? (e.g. photography, drafting or computer skills, etc.)
What are your hobbies and interests?
Do you plan to receive credit for this internship?
Describe what experiences and skills you are seeking to gain from an internship?
Describe what skills and experience you can offer to an internship
Would you like an E-mail confirmation when your application is received?