Internship Application 2017-2018
First Name *
Last Name *
Parents Email *
Addresss *
Your Cell Phone *
Parents Cell Phone *
Is your possible internship on or off campus? *
List the mentor (teacher/business) you are requesting to work with. - With *
List the mentor's email address *
List the mentor (teacher/business) phone or room number *
Have you personally discussed being an intern with the mentor (teacher/business) you have listed?- Yes
Check any that apply
Check the following that apply in order to help us determine if an internship will fit you as a student. *
Have you had any discipline issues at CCHS? *
List any comments or concerns you have
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