Intern request Form
The e3 Civic High Intern Request Form 2016 and application period is open. Prior to filling out this form, please read carefully about our Intern Program on our Internships Page at
. Once you have completed this form, you will receive a confirmation e-mail. Soon after, you will be contacted to confirm if we can place an intern at your site.
Employer and Site Information
Employer - Company or Organization that is requesting to host intern(s)
Department - What department or division of the company/organization will the intern work in?
Industry Field - What industry sector or career field does this company/organization best fall under?
Agriculture and Natural Resources
Education, Child Development, and Family Services
Manufacturing and Product Development
Fashion and Interior Design
Health Sciences and Medical Technolog
Building and Construction Trades
Hospitality, Tourism, and Recreation
Energy, Environment, and Utilities
Arts, Media, and Entertainment
Information and Communication Technologies
Business and Finance
Engineering and Architecture
Marketing, Sales, and Services
Internship Site Address
Intern Supervisory Contact Information
The information provided in this section should pertain to the individual on site who will be the contact and will directly oversee and evaluate the intern.
Mobile Phone (optional)
Work Mailing Address (if different )
New / Returning?
New Supervisor, I have never hosted an e3 Civic High Intern before
New Supervisor, I have never hosted an e3 Civic High Intern before, but I have hosted other interns from local colleges or high schools.
Returning, I have hosted an e3 Civic High Intern
How did you hear about the e3 Civic High Internship Program?
Internship Position Information
Intern Job Title
How many openings?
If so, what is the age requirement?
When would you like an intern to begin?
Yearlong September - June (Wednesdays Only)
Fall Semester January - February (Monday, Tuesday, Thursday & Friday)
Spring Semester February - June (Monday, Tuesday, Thursday & Friday)
Other Info or Comments
Thank you for taking the time to fill out the Intern Request Form. Please check to be sure you have accurately answered all questions and then click the submit button below. You will receive an automatic confirmation email to verify we have received your application request. We will then contact you shortly to confirm whether or not we can place an intern at your site.
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