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Eco-Gap Internship Application Form - Spring or Summer 2019
This is the Application Form you should be using to apply for the Eco-Gap Internship Program that takes place between April 1st and July 31st. You will choose the dates within that time period that you could like to participate.
Email address *
Your Personal Information
Your First and Second Name(s) *
Your answer
Your Last or Family Name(s) *
Your answer
Your Street Address *
Your answer
City and Zip Code *
Your answer
Country of Residence *
Your answer
Your Phone Number *
Your answer
What is your gender or pronoun preference? *
Your answer
What is your birthdate? (day, month and year) *
Your answer
Your Interests
What are your current interests and passions? What captivates you? (about 100-250 words) *
Your answer
The Eco-Gap Internship Program will allow you explore issues concerning sustainable living and social justice - on a personal and global scale. What are some of your interests in these realms and which you'd like to explore more deeply? (100-250 words)
Your answer
Are you especially interested in any of the following? *
We are looking for a diverse group of young adults. Please tell us about your personal, educational, work, volunteering, and/or organizing background. Tell us how you bring a unique perspective. What makes you stand out? We want to know! (about 100-250 words) *
Your answer
What are the dates that you are interested in participating in the Eco-Gap Internship Program? Please give us a time frame between April 1st and July 31st, 2019. How many weeks would you like to participate? *
Your answer
REFERENCES: Please provide us with the name of 2 references we can contact to get a better sense of who you are. These should be adults who have known you for some time such as teachers, bosses, volunteer coordinators, mentors, therapists, friends of your parents, etc. Please do NOT list your parents.
We recommend that you tell these references that we may be contacting them soon and that you let them know about Eco-Gap and your plans.
First and Last Name of Reference #1: *
Your answer
Email Address of Reference #1: *
Your answer
Phone Number of Reference #1: *
Your answer
First and Last Name of Reference #2: *
Your answer
Email Address of Reference #2: *
Your answer
Phone Number of Reference #2: *
Your answer
Program Costs
The Eco-Gap Internship Program costs $350 per week. You can participate for a time period of between 2 and 10 weeks. Will you be able to afford to pay for the time you are requesting? *
Your answer
Lastly ...
How or where or from whom did you learn about Eco-Gap? (Please be as specific as possible.) *
Your answer
Is there anything else you'd like us to know about you?
Your answer
A copy of your responses will be emailed to the address you provided.
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