Last Name
Street Address
City
Primary Phone
First
Email address:
Have you ever been convicted of a felony?
Yes
No
State
Alternate Phone
How did you hear about our internship program?
Zip
If yes please explain:
Date
Apt/Unit
Please check all days and hours of availability:
Please check your general availability
Morning
(approx. 9-1)
Afternoon
(approx. 1-5)
Sunday Monday Tuesday Wednesday Thursday
Evening
(approx. 5-9)
Friday Saturday
Please indicate which area interests you:
Public
Relations
Photography
Administration
Digital Editing
(photo or video)
Fashion
TV/Film
Marketing
Other, please explain: ____________________________
Current employment status: Full-time Part-time Not Employed
Current or most recent paid position held
Are you currently a full-time student?
Yes No
If yes, please indicate school and concentration:
Areas of study: Level
Freshmen Sophomore Junior
Senior Graduate student
Do you speak any other languages? If yes, please list language

Yes No
Computer Skills/Software Used:
Fluent Semi-Fluent Basic
Why are you interested in an internship in our organization?
What specific experience would you like to gain through this internship?
Describe your long-term career goals:
I certify that my answers are true and complete to the best of my knowledge. If this application leads to an internship assignment, I understand that false or misleading information in my application may result in my release.
*I authorize and acknowledge that my e-signature (electronic, copied, scanned) signature represents my true signature.
E-Signature: Date: