Internship

Intern Employment Application

Step 1 of 2

• Position Desired

Internship

• Name*

First

Last

• Date*

• Email*

• Phone Number*

• Cell Phone Number

• Address

Street Address

Address Line 2

City

State

ZIP Code

• Date Available to start work:*

• How were you referred to us?*

Career Fair

Job Post

TPA Employee

Social Media

• What career fair was it?

• Name of the employee

• Where was the job posted?

• What platform of social media?

• Are you able to meet the attendance requirements?*

• Yes

• No

• Do you have any objection to working overtime (if necessary)?*

• Yes

• No

• Have you been previously employed by our organization?*

• Yes

• No

• If under 18, can you furnish a work permit if it is required?*

• Yes

• No

• If yes, please explain (a conviction will not automatically bar employment):*

• If any of the information requested below is on your resume you are not required to fill it out.

• Other Skills and Qualification

Summarize any job-related training, skills, licenses, certificates, software experience:

• Educational History

List school name and location, years completed, course of study, and any degrees earned: this includes high school, college, technical training, and other.

| Name | Location / City | Years Completed | Course of Study | Degrees Earned | | | --- | --- | --- | --- | --- | --- | | | | | | | |

• References

List three (3) reference names, phone numbers, and years known (do not include relatives)

| Name | Number | Years Known | | | --- | --- | --- | --- | | | | | |

• Upload your resume (doc, txt, or pdf files only)

Drop files here or

Accepted file types: doc, txt, pdf, docx.

• Are you willing to take a drug test?*

• Yes

• No

• Upload you drug consent form (doc, txt, or pdf files only)

Drop files here or

Accepted file types: doc, txt, pdf, docx.

• Comments or Cover Letter

• CAPTCHA

• Comments

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