Secondary Education Internship Form
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Last Name *
First Name *
ID Number *
Cell Phone Number *
Home Phone Number
E-mail Address *
Counselor *
Please list any languages you speak other than English
Check the department in which you would like to intern: *
Required
Staff member with whom you would like to intern: *
Course you would like to intern in with the above teacher: *
Please indicate why you are interested in the Education Internship Program. *
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This form was created inside of Township High School District 211.

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