EmailMe Form - College Internship Application

Name *

First Last

Phone

### - ### - ####

Email

Address

Street Address City State / Province / Region Postal / Zip Code Country / Region

Emergency Contact Name

Emergency Contact Phone

### - ### - ####

University Name *

Program of Study *

Program Director or Advisor's Name *

PD or Advisor's Phone

### - ### - ####

PD or Advisor's Email

Internship Requirments *

Please list any specific requirements for your internship that you have been given by your Advisor or Program Director. Please include the number of hours you need, specific duties you must perform, reports or paperwork that need to be completed, etc.

Date Available to Start *

MM / DD / YYYY

Deadline Date for Completion *

MM / DD / YYYY

What prior community service or vounteer work have you done? *

Please tell us about your college experience. (Accomplishments, awards, clubs, sports, etc.) *

What do you know about REACH Council, and what do you hope to gain from an internship with us? *

What are your internship and/or career goals? *

Background Check & Drug Screen *

I agree

By clicking the "I Agree" button above, you are confirming that you will abide by and comply with REACH policies and principles. You further understand that in order to work with the youth and families that we serve, you will be required to consent to a bacground check and drug screen.

Photo/Video Release

I Agree

By clicking the "I Agree" button above, you confirm that you understand that REACH Council frequently takes photographs and/or videos during our events, programs and presentations, and that you may be featured in such photos or videos. You further agree that you authorize REACH to use those photographs or videos without restriction or compensation to you, including but not limited to, newspaper print, website publication, etc.

Resume

Please upload your resume. File types .pdf, .doc or .docx are acceptable.

References

Please upload your references. File types .pdf, .doc or .docx are acceptable.