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Internship Application Form
Date of Application:Required Entry
EMPLOYER SECTION
1. EMPLOYER INFORMATION:
Company Name:
Manager Name
LAST NAME:
FIRST NAME:
E-mail:
Address:
Phone Number:
City:
State:
ZIP
2. List the skills you would like the intern to possess
1)
2)
3)
4)
INTERN SECTION
2. INTERN INFORMATION:
Intern Name
LAST NAME:
FIRST NAME:
Middle Initial:
DOB
Age
E-mail:
Address:
Phone Number:
City:
State:
ZIP
3. Classes/Program Currently Enrolled In(with START & END Date)
1)
2)
3)
4)
4. Desired Internship Position and Name of Supervisor
5. Reason for Applying to Internship
6. What are your future goals and how will this internship help
7. Class you Plan On Attending as Internship Compensation
Please give Names of Class, START and END Dates
1) CLASS,Start and End Dates
8. Are you getting any Financial Assistance? (List Name & Type)
1)
2)
3)
9. Hours of Availability for Internship Hours:
Sunday
From (Hour):
To (Hour):
Monday
From (Hour):
To (Hour):
Tuesday
From (Hour):
To (Hour):
Wednesday
From (Hour):
To (Hour):
Thursday
From (Hour):
To (Hour):
Friday
From (Hour):
To (Hour):
Saturday
From (Hour):
To (Hour):
INTERNSHIP POLICIES
In order to successfully complete our Internship program, students need to complete 144 total internship hours. Students are recommended to complete 12 Hours per week for three consecutive months. Only interns who complete the required 144 Hours can take a FREE CLASS here at The Academy (exams are NEVER INCLUDED). Interns need to complete their required Internship hours within four months of starting the internship program.

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