Mecklenburg County Public Schools
Technology Internship Application
Applicant Information
Last Name:
Your answer
First Name:
Your answer
Street Address:
Your answer
City:
Your answer
State:
Your answer
Zip:
Your answer
Phone:
Your answer
Cell Phone:
Your answer
Email Address:
Your answer
How did you hear about our internship program?
Your answer
Availability
General Availability
(Check all that apply)
Required
Vacation Dates
Your answer
Areas of Interest
Please indicate which area(s) interest(s) you:
(Check all that apply)
Required
Education/Employment
Current Employment Status
Are you currently a full-time student?
If you answered "Yes" above, please indicate school you currently attend:
Your answer
Grade Level:
Computer Skills/Software Used:
Your answer
Personal Information
Why are you interested in an internship in our organization?
Your answer
What specific experience would you like to gain through this internship?
Your answer
Describe your long-term goals:
Your answer
Professional References
Please provide three references. If your are a Mecklenburg County Public School student, please use at least two teachers as references.
Reference 1
First/Last Name
Your answer
Relationship
Your answer
Email Address
Your answer
Reference 2
First/Last Name
Your answer
Relationship
Your answer
Email Address
Your answer
Reference 3
First/Last Name
Your answer
Relationship
Your answer
Email Address
Your answer
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to an internship assignment, I understand that false or misleading information in my application may result in my release.
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