MMYC Internship Program
LAYC/MARYLAND MULTICULTURAL YOUTH CENTERS
2016 Summer Youth Connect
Application
Please include this in your
application packet due by June 2
nd
, 2016.
If you have any questions contact Marilyn Calderon at marilyn@layc-dc.org or 301-495-0441
ext. 224
Date:
First Name:
Middle Initial:
Street Address:
City:
Home Phone:
Last Name:
Apt. #:
State:
Cell
Phone:
Age:
Date of Birth:
Foreign Language:
First and last name:
Relationship to Applicant:
Zip:
Email:
Gender:
Male
Female
Emergency Contact Information
Phone Number:
Transportation: Please indicate how you will get to your internship
 Public Transportation
 Car
 Bike
 Walk
Work Experience: Please list two employers (paid or volunteer)
Organization/Position
City, State, Zip
Phone # and
Start/End
Supervisor
Dates
Name
 Other
Volunteer
Education
School Name:
City:
What grade are you in?
GED: YES
Student ID # :
State:
Did you officially withdraw?
NO
Zip:
YES
NO
Are you in College:
1st year 2nd year 3rd year 4th year
Applications can be mailed, emailed, faxed
Email: marilyn@layc-dc.org
Fax: 301.585.0115
Address: 8700 Georgia Ave. Suite 500 Silver Spring, MD 20910
If you have any questions contact Marilyn Calderon at marilyn@layc-dc.org or 301-495-0441 ext. 224
MMYC Internship Program
LAYC/MARYLAND MULTICULTURAL YOUTH CENTERS
2016 Summer Youth Connect
Application
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Check the type of jobs that interest you the MOST
Working with Senior Citizens
 Working with Children

Working with
 Journalism /New

Nature/Environment
Reporting
Sports & Recreation
 Video Production

Animals
 Social Media

Receptionist /Front Desk
 Government Work

Arts and Crafts
 Culinary/Food Service

Automotive
 Construcion

Fire Fighting /Law Enforcement
 Medical/Nursing

 Computer/Information
Technology (IT)
Office Work
Health Care/ Science
Theatre/Play /Dance
Organizing paperwork
Electrical
Banking/Financial
Social Work
I’m open to anything
 Other, describe:
Do you work (circle one): Yes or No
Your Schedule
Do you have other family obligations (circle one): Yes
or No
Are you available weekends (circle one):
Yes or No
Check the type of skills proficiency you have
 Microsoft Office-basic
 Microsoft Office Microsoft Officeintermediate
advanced
 Typing-basic
 Typing-intermediate
 Typing-advanced
 Filing-basic
 Filing-intermediate
 Filing-advanced
 Foreign language-basic
 Foreign languageintermediate
 Foreign languageadvanced
If you have a job or other commitments, please provided your schedule
Sunday
Start:
Monday
Start:
Tuesday
Start:
Wednesday Thursday
Start:
Start:
Friday
Start:
Saturday
Start:
End:
End:
End:
End:
End:
End:
End: