Intern Interest Form
Thank you for taking a few moments to apply to become an intern with Communities In Schools of North Texas. The gift of time is one of the greatest gifts you can provide to us. As you begin your journey by completing this brief intern application, please realize that we commit to stand by you and do everything possible to make your volunteer experience with Communities In Schools of North Texas rewarding.

We are currently accepting interns for the Fall 2017 Semester.

There are four primary steps in your application to become a Communities In Schools of North Texas volunteer.

1) Submit application.
2) Pass a criminal background check.
3) Schedule a meeting with the CISNT Program Director, Connie Kim at ckim@cisnt.org or call 972-538-9922.
4) Attend an Intern Orientation.
5) Campus assignment for internship.

CISNT is required by state law to obtain criminal history record information on volunteer applicants being considered with CISNT. (Texas Education Code 21.917) The information set forth will be used by CISNT for the purpose of obtaining criminal history record information for determining eligibility to serve as a CISNT volunteer.

Personal Information
1. Title *
2. First Name *
Your answer
3. Middle Name
Your answer
4. Last Name *
Your answer
6. E-mail *
Your answer
7. Phone *
Your answer
16. Level of Education
(please select highest level completed)
18. How did you find out about us?
Your answer
Languages
19. Spoken Languages
Check all languages that you speak (optional)
Emergency Contact
In the unlikely event of an emergency, please provide:
22.a. Emergency Contact Name *
Your answer
22.a. Emergency Contact Phone Number *
Your answer
Class Requirement
24.a. Name of School *
Your answer
24.e. Instructor/Teacher: *
Your answer
Major *
24.c. Semester *
We are currently not accepting interns for the summer semester.
24.d. Semester Year *
Your answer
24.f. Total Intern Hours Needed *
Your answer
Location and Grade Level Interest
25. District Interest *
At which Independent School District are you most interested in volunteering?
Required
26. Grade Level Interest *
I am most interested helping Communities In Schools of North Texas at-risk students at the following grade levels:
Required
Intern Certifications and Agreement
Please read this carefully before continuing.

Communities In Schools of North Texas appreciates your interest in donating time as a volunteer to help kids succeed. In order to continue to achieve the outstanding results our program has produced since 1994, we respectfully request that you take this volunteer position as seriously as any effort you would be financially compensated for by agreeing to the following:

32. Intern Confidentiality Agreement *
Interns will, to the best of their ability, ensure confidentiality and privacy in regard to history, records, and the services provided to students and family members of Communities In Schools of North Texas. All participation regarding services received in the CISNT program will be kept confidential. Disclosure can be made only under specific conditions including any situation in which the student or another individual is in danger of receiving bodily harm. I have read the above information regarding CISNT policy on the subject of participant confidentiality. I agree to respect the policy and maintain the privacy of individuals served in the CISNT program.
Required
31.c. Intern Orientations *
I agree to attend initial intern training session(s) to increase my effectiveness as a CISNT intern.
Required
Signature and Date
Completing the signature and date field below serves as your signature and completion of the Volunteer Application & Background Check.
Signature of Intern Applicant *
Your answer
Date of Signature *
(MM/DD/YYYY)
Your answer
Submit
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