Ingenuity Internship Application
Currently I am a: *
First Name *
Your answer
Last Name *
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Date of Birth *
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Gender *
Home Address *
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City *
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State *
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Zip *
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Cell Phone Number *
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Email *
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Do you have access to a computer?
Career Ambitions
What is your career goal?
(Career of Interest)
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In four sentences, please describe why your interested in an internship with Ingenuity College Preparatory Inst.?
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Are you a current or former participant of Ingenuity College Preparatory Inst.? *
If yes, please type the year you participated
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Education
Grade *
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Graduation Year *
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Current Overall G.P.A *
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School Name *
Your answer
School City & State *
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Parent/ Guardian Information
Parent or Guardian Name *
First & Last
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Address (if different from student's)
Address, City,State, Zip
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Phone Number *
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Email *
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Medical Information
Do you have any medical conditions or allergies, please specify:
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Emergency Contact Information
Emergency Contact *
First & Last Name
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Emergency Contact Relationship to Participant *
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Emergency Contact Cell Phone Number *
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Emergency Contact Home Phone Number *
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Emergency Contact Email
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Emergency Contact Work Phone Number
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Schedule
List any extracurricular activities and or hobbies you participate in: *
Indicate NA if you currently do not participate in any activities.
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Do you currently work? If so, please list location and schedule (days & hours):
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