PROTEC Application 2021
Please complete the following application form.
First Name
Last Name
Home - street address
City
State
Zip code
Email address
Phone number
Age Group: *
Gender
Clear selection
Ethnicity
Current Work or Training Status
Do you have access to any of the following from home and can you use them for distance learning:
Are you familiar with any of the following forms of working remotely:
Have you ever participated in an internship or on-the-job training program before? If so, please share a few details of your experience with interning:
What interests, talents, or skills do you bring to this PROTEC training as well as online internship program?
What kind of internships or career pathways are you most interested in exploring?
If you currently have a personal website OR facebook or instagram page you are willing to share, please include. (We will be working on updating resumes and linked profiles during the program)
I am available to meet for periodic PROTEC zoom calls (check all that apply)
I am interested and available for a paid internship April through June 30, 2021
Clear selection
What obstacles could impact my participation and success in the PROTEC online training and internship program?
How did you hear about PROTEC?
Please include anything else you would like us to know or consider:
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