Internship Application Please complete the application. "*" indicates required fields Step 1 of 4 25% URLThis field is for validation purposes and should be left unchanged.Name* First Last Date of Birth* MM slash DD slash YYYY Local Address:* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Permanent Address:*(If different) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address:* Phone #1*Phone #2Optional ACADEMIC INFORMATIONUniversity/College:Classification:Major:GPA: INTERNSHIP QUESTIONSHow did you hear about the internship?I am applying for the following semester:FallSpringWinterSummerPlease identify days you can work: Monday Tuesday Wednesday Thursday Friday Select AllPlease type the time the time frame you will like to work for each day. Please respond to the questions below:Why are you interested in this internship?Why should we consider you for this internship?Interests Grant Writing Community Development Communications/Marketing Research skills Administration/Customer Service/People Management Event Planning Select AllHow do you organize your time and prioritize tasks during a busy day?What do you plan to do after you graduate?Aside from your regular intern hours, will you be available to participate in Clyburn Foundation's events?NoYesSignature
