Riverdale Neighborhood House
Youth Internship Program Application Form
2015-2016
2008-2009
Applications must be submitted on or before Friday,
October 9, 2015.
The Riverdale Neighborhood House Youth Internship Program is a stipend-based paid
internship. If you are a high school student between the ages of 14 and 18 looking to develop job
skills, explore careers, and gain experiences that will boost your resume and/or college application
then you are encouraged to apply. Selected interns participate in various activities to enhance
their experience including career club, academic assistance, college information, health & mental
health education, peer-to-peer education, trips, and year-end events.
one of the 2 internship programs:
School Year Internship (Late October- June):
You may only apply to
Health, Education or Environment
OR
Fall Internship (Late October-February):
Media and Broadcasting & Group Leader Assistant
If applying you must submit the following:
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Internship Application (1 page)
Intern YIP Blog (must be typed)
2 Reference Forms
Working papers (to be submitted if accepted)
When you are satisfied with your completed application please mail or bring to:
Attention: Teen Program
Riverdale Neighborhood House
5521 Mosholu Avenue
Bronx, New York 10471
*Only selected candidates will be contacted for an interview. *
For further information, please contact Teen Program @ (718) 549-8100 ext. 112 or
Visit our website www.riverdaleonline.org and download the application.
(Faxed or emailed applications will not be accepted)
Riverdale Neighborhood House
Internship Application Form 2015-2016
I. Applicant’s Contact Information (Please print clearly using a blue or black ink pen.)
Name: _______________________
(Last)
_______________________
__________
(First)
(Middle Initial)
Address: _______________________________________________________________________________
(Street)
Telephone: (
(Apt)
(City)
) __________ __________
(
(State)
(Zip)
) __________  __________
(Home)
(Cell)
E-mail: ________________________________________________
Date of Birth: ______/______ /______
Age: ______
Gender: Female ____ Male ____
II. Education
Name of School: _____________________________ Borough: ___________ Grade: _____
Please list any current after school activities and the days and time it meets:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
III. Parent or Guardian Contact Information
Name: _____________________________
_________________________________
(Last)
Telephone: (
(First)
) ________ ________
(
) ________ ________
(Home or cell)
(Work)
Name: _____________________________
_________________________________
(Last)
Telephone: (
(First)
) ________ ________
(
(Home or cell)
) ________ ________
(Work)
IV. Work Experience (Please list all previous employment, internship, and volunteer/ community service experience.)
1. __________________________
(Name of company/organization)
2. __________________________
(Name of company/organization)
3. __________________________
(Name of company/organization)
_______________
___ / ___ to ___ / ___
(Position)
Mo
_______________
___ / ___ to ___ / ___
(Position)
Mo
_______________
___ / ___ to ___ / ___
(Position)
Mo
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Yr
Yr
Mo
Mo
Mo
Yr
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Riverdale Neighborhood House
Internship Application Form 2015-2016
School Year Internship (Late October- June)
Health, Education or Environment
A. Education Internship
1. Riverdale Neighborhood House
The Learn, Educate and Develop (L.E.A.D) internship at Riverdale Neighborhood House
provides young people the opportunity to work side by side with professionals in an afterschool setting. Working with young children in a classroom and library setting, teens will
have the chance to develop skills required for promoting literacy and learn group
management skills. Interns work Tuesdays and Wednesdays from 4:00 p.m. – 6:00 p.m.
for a total of 4hrs/week plus every other Friday from 4:30 p.m. – 6:00 p.m.
B. Health Internship (3 sites)
1. Hudson Pointe at Riverdale, Center for Nursing and Rehabilitation
2. Hebrew Home for the Aged at Riverdale
This health internship offers young people an opportunity to intern in a nursing care facility
working with the elderly. Interns will work alongside health care professionals to learn
about the career and develop the skills to care for the residents. Interns will also participate
in various social and recreational activities. Work days are to be determined, but interns
will work a total of 4hrs/week plus every other Friday from 4:30 p.m. – 6:00 p.m. Interns
must be 16 years old or older and will need a current medical form, PPD and MMR
and flu vaccine to intern at this site.
3. Montefiore Medical Center
This health internship offers young people an opportunity to intern at a nationally
recognized medical center and hospital. Interns will either be placed in the Volunteer
Department or nursing section to support the Montefiore staff, as well as, to learn about
different health fields. Work days are to be determined, but interns will work a total of
4hrs/week plus every other Friday from 4:30 p.m. – 6:00 p.m. Interns must be 16 years
old or older and will need a current medical form, PPD and MMR and flu vaccine to
intern at this site. Interns must be able to attend work by 2:30 p.m.
C. Environmental Internship
Friends of Van Cortlandt Park
Held in partnership with the Friends of Van Cortlandt Park, the Environmental Internship
connects youth to the environment and their community. Our mission is to give youth from
the Bronx and surrounding communities an opportunity to learn about improving and
conserving their local environment, specifically Van Cortlandt Park, as well as the chance
to gain valuable job skills. As an intern, you will be highly involved in two different projects
this upcoming year within the park: watershed quality testing and trail maintenance.
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During this internship, you will learn about general environmental topics including water
quality testing, macroinvertebrate and plant surveys, chemical testing, plant identification,
and much more. Interns work every Wednesday from 4:30-6:00 p.m. and alternate
scheduled Saturdays from 9:30a.m.-2:30p.m. as well as every other Friday meetings at
RNH from 4:30-6:00 p.m.
Fall Internship (Late October-February)
NYC Public Library, Media and Broadcasting or Bronx Community Board
A. Media and Broadcasting Internship
BronxNet
BronxNet, located on the Lehman College campus, is home to the Bronx’s only public
access television station and offers diverse programming showcasing the Bronx. Interns
will get a behind-the-scenes look on how a television station operates and of the various
careers in this field. Teens will learn about studio production, editing, and camera
operation as they create their own field-production packages that will be broadcasted at
the Open 2.0 show; a show created by teens for teens. This internship is for a motivated,
hands-on, and creative teen that wants to expand their knowledge about media and
broadcasting. Interns work Mondays and Wednesdays 4:00 p.m. – 6:00 p.m. for a total of
4hrs/week plus monthly Friday meetings.
B. Group Leader Assistant
The SONYC Middle School Program at Riverdale Neighborhood House
The SONYC program is a structured afterschool program for 6th, 7th, & 8th graders located
at Riverdale Neighborhood House. As an intern, you will support the Group Leader and
assist in various activities including homework help, games, and sport activities. The
internship is ideal for creative and active teens comfortable with working with middle
school children. Work days are to be determined, but interns will work a total of 4hrs/week
plus monthly Friday meetings.
***All dates and times are subject to change***
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Riverdale Neighborhood House
Internship Application Form 2015-2016
VII. Internship Selection (Please select the internship program that best suits your interest)
** You may only apply to one internship program: Either the school year or fall
program --- DO NOT apply to both programs.
Youth Internship Program -School Year
(Please select your 1st, 2nd & 3rd choice)
____Environmental Internship
____ Health Internship
Friends of Van Cortlandt Park
Program Dates: Late October-June
(Check off your site preference)
____ Hudson Pointe at Riverdale
____ Hebrew Home at Riverdale
____ Montefiore Medical Center
Program Dates: Late October-June
____ Education Internship
Riverdale Neighborhood House
Program Dates: Late October-June
Youth Internship Program- Fall
(Please select your 1st & 2nd choice)
____ Media & Broadcasting Internship
BronxNet- Lehman College Campus
Program Dates: Late October - February
_____Group Leader Assistant
Riverdale Neighborhood House
Program Dates: Late October-February
VIII. References
The last two pages include 2 reference forms. Please identify and give to two (2) reliable people
(teachers/guidance counselors, coaches, club advisors, previous employers, family friends, or
neighbors) who can vouch for your good character and who have known you for at least six
months. Please ensure that the reference forms are returned with the completed application
Attn: Teen Program.
I hereby certify that the information listed in this Youth Internship Program application is true
and
Rev. 8/2014
complete.
Riverdale Neighborhood House
Internship Application Form 2014-2015
Signature: _________________________________________
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Date: _______________
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VIII. YIP Blog
On a separate page, blog about why we should hire you. Describe yourself and your career goals.
What are your expectations of having a job and being part of an internship program?
Like most blogs, this blog is informal and describes your own experiences and observations. Your
blog should be at least 150 words and MUST be typed. DON’T FORGET TO CHECK YOUR
GRAMMAR AND SPELLING. IT COUNTS!!
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Rev. 7/2012
Reference Form
Riverdale Neighborhood House
Youth Internship Program 2015-2016
Name of applicant: _______________________________
Program: ________
(Please print)
To Whom It May Concern,
The applicant named above has applied for one of our internships at Riverdale Neighborhood
House. As a part of our application process, we require each applicant to obtain two references,
which will assist in our selection process. Please rate the applicant objectively based on your
personal or professional relationship.
Thank You
Name of reference: ________________________________
(Please print)
Please rate the applicant by the following criteria:
Excellent
Competence/Ability to learn
and perform assigned tasks
Leadership skills
Interpersonal skills
Creativity
Dress & Personal
Appearance
Dependability
Quality of work and
workmanship
Initiative
Cooperation
Ability to work with
others/ teamwork
Patience
I know this applicant as:
Very Good
Average
Below Average
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Student
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Other ______________________
If employed, list their duties: _____________________________________________________
Remarks: ______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please return completed reference form to applicant in a sealed envelope Attn: Teen Program. If you have any additional
questions or concerns please contact me at (718) 549-8100.
Reference Signature___________________________________________ Date ___________
Position/Title_______________________________
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Telephone: (
) ________ ________
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Reference Form
Reference Form
Riverdale Neighborhood House
Youth Internship Program 2015-2016
Name of applicant: _______________________________
Program: ________
(Please print)
To Whom It May Concern,
The applicant named above has applied for one of our internships at Riverdale Neighborhood
House. As a part of our application process, we require each applicant to obtain two references,
which will assist in our selection process. Please rate the applicant objectively based on your
personal or professional relationship.
Thank You
Name of reference: ________________________________
(Please print)
Please rate the applicant by the following criteria:
Excellent
Competence/Ability to learn
and perform assigned tasks
Leadership skills
Interpersonal skills
Creativity
Dress & Personal
Appearance
Dependability
Quality of work and
workmanship
Initiative
Cooperation
Ability to work with
others/ teamwork
Patience
I know this applicant as:
Very Good
Average
Below Average
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Student
Employee
Other ______________________
If employed, list their duties: _____________________________________________________
Remarks: ______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please return completed reference form to applicant in a sealed envelope Attn: Teen Program. If you have any additional
questions or concerns please contact me at (718) 549-8100.
Reference Signature___________________________________________ Date ___________
Position/Title_______________________________
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Telephone: (
) ________ ________
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