2017-18 Food Systems Program Internship Application
If you have any questions about this application or the positions, contact Stephanie Onderchanin, Program Manager, at stephanieo@nwlansing.org or 517-999-2894.

It is required that all volunteers and interns pass a background check before working in our programs. Some of the information collected in this application will be used for that.

Email address *
Personal Information
First and last name: *
Your answer
Gender (necessary for background check): *
Street Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip code: *
Your answer
Phone number: *
Your answer
Birth date (necessary for background check): *
MM
/
DD
/
YYYY
Ethnicity (necessary for background check): *
Race (necessary for background check): *
Required
Emergency contact: *
Name, phone number
Your answer
Education and Work Experience
Current employer:
Your answer
Highest level of education completed: *
Current education level (if applicable):
Your answer
Area of study:
Your answer
Are you interning to fulfill a requirement? *
If you are interning to fulfill a requirement, please specify the reason and provide the name and contact of your adviser.
Your answer
List special talents, skills, or areas of interest (e.g. gardening, music, sports, public relations/media, languages, etc.):
Your answer
Availability and Preferences
Which internship are you applying for?
Which semester(s) are you applying for? *
Required
Please list the times for each day you are available. For example, under Tuesday you might list 12 – 3, etc.
Monday
Your answer
Tuesday
Your answer
Wednesday
Your answer
Thursday
Your answer
Friday
Your answer
Total hours per week:
Your answer
Reference 1
Please list two references with phone numbers and e-mail addresses; employment, school, previous volunteer references preferred.
Name:
Your answer
Phone number:
Your answer
Email:
Your answer
Relationship to applicant:
Your answer
Reference 2
Name:
Your answer
Phone number:
Your answer
Email:
Your answer
Relationship to applicant:
Your answer
Additional Information
How did you hear about the Food Systems Project and/or Northwest Initiative? *
Your answer
I affirm that the information I have given on this form is true and correct.

As a condition of volunteering or interning, I give permission for the Food Systems Project (Northwest Initiative) to conduct a background check on me.

I hereby grant the Food Systems Project (Northwest Initiative) the right and license to use, reproduce, display, and distribute, in whole or in part, any photographs and/or recordings taken of me during activities sponsored by Food Systems Project (Northwest Initiative).

*
If you agree to this, please type your name and today's date in the box below.
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