Internship Application Please complete the application. "*" indicates required fields Step 1 of 4 25% 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?NoYesSignatureNameThis field is for validation purposes and should be left unchanged.
