Youth Resources of Southwestern Indiana TEENPOWER Summer Internship

Applicant Information

Applicant Name

First

Last

School Address *

Address Line 1

Address Line 2

City

State

Zip Code

Permanent/Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone *

Home Phone

Personal Email *

School Email *

Which email do you prefer we use for communication? *

Personal
School

Preferred Pronouns

She/her
He/him
They/them
Other

Check all that apply.

What pronouns do you prefer? *

Employment Eligibility

Are you legally eligible to work in the United States? *

If no, please explain. *

If you are not a U.S. citizen, are there any restrictions on your eligibility for employment? *

If yes, please explain. *

Are you requesting that your college grant you credit hours for your internship? *

Yes
No
Not sure

If yes, please explain what Youth Resources will be required to do to ensure your credit is received (to your knowledge at this time). *

Start Date: *

Requested internship start date

End Date: *

Requested internship end date

Education

High School Attended *

Name and Location

High School Graduation *

MM/YYYY

Are you currently attending a post-secondary instituation? *

If no, please explain your current work and/or education plans. *

If yes, which post-secondary institution? *

Name and location

Expected Graduation *

MM/YYYY

Major *

Scholastic Honors and/or Licenses

Employment History

Below you have the opportunity to list two previous jobs. You may include paid, volunteer & intern positions. If you have not worked before, please skip these questions and go to the next section.

Most Recent Employer

Company Name

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Supervisor Name

First

Last

Supervisor Title

Your Position Title

Start Date

MM/YYYY

End Date

MM/YYYY - If you are currently employed here, please type "N/A".

Description of Duties

Other Past Employer

Company Name

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Supervisor Name

First

Last

Supervisor Title

Your Position Title

Start Date

MM/YYYY

End Date

MM/YYYY

Description of Duties

References

Please list three (3) character references (no relatives or YR staff) and their contact information.

Reference #1

Reference #1 Name *

First

Last

Work Phone *

Cell Phone (If applicable)

Company/School *

Relationship to You *

How long have you known this reference? *

Reference #2

Reference #2 Name *

First

Last

Work Phone *

Cell Phone (If applicable)

Company/School *

Relationship to You *

How long have you known this reference? *

Reference #3

Reference #3 Name *

First

Last

Work Phone *

Cell Phone (If applicable)

Company/School *

Relationship to You *

How long have you known this reference? *

Additional Information

Why would you like to work as a Youth Resources intern? *

Activities relevant to the internship for which you are applying:

General description of activities

Community/school/professional organizations, honors & awards:

Names and dates involved/received

Résumé & Cover Letter

Please upload your résumé and cover letter here.

File Upload *

Click or drag files to this area to upload. You can upload up to 2 files.

Health, Liability & Photo Release

Please upload your completed Health, Liability & Photo Release forms in the box below. To download the forms click here. We recommend Adobe Scan or Genius Scan apps if you don't have access to a scanner.

File Upload *

Click or drag files to this area to upload. You can upload up to 2 files.

I certify that all of the statements in this application are true and complete to the best of my knowledge. I understand that a false or incomplete answer may be grounds for not considering me or for my dismissal.

Electronic Signature *

Type your first and last name above as an electronic signature.

TEENPOWER SUMMER INTERNSHIP APPLICATION

ALL MATERIALS DUE APRIL 3, 2023

Applicant Information

Employment Eligibility

Education

Employment History

Most Recent Employer

Other Past Employer

References

Reference #1

Reference #2

Reference #3

Additional Information

Résumé & Cover Letter

Health, Liability & Photo Release

I certify that all of the statements in this application are true and complete to the best of my knowledge. I understand that a false or incomplete answer may be grounds for not considering me or for my dismissal.

youthresources