High School Youth Internship Program - Summer 2021
Will you be graduating in 2022 or 2023 school year and attend school in Antioch? Then what are you waiting for?! Apply to be a part of a 3-week PAID internship! By becoming an intern you will:

- Work for the City of Antioch
- Gain work experience
- Meet other youth in Antioch
- GET PAID!!!
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Email *
First and Last Name *
Address (Apt.#, City, State, and Zip Code) *
(Apt.#, City, State, and Zip Code)
Cell Phone Number *
Is it OK to send text? *
Can we add you to our email list to learn about upcoming opportunities, events, and activities? *
Email *
School *
Grade in Fall 2021 (after summer is over, what grade would you be in?) *
PARENT / LEGAL GUARDIAN CONTACT INFORMATION
First and Last Name (of Parent or Legal Guardian) *
Relationship to Student *
Address (Apt.#, City, State, and Zip Code) *
(Apt.#, City, State, and Zip Code)
Best Phone Number *
Is it OK to text? *
Can we add you (Parent or Legal Guardian) to our email list to learn about upcoming youth opportunities, events, and activities?
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Email
(Parent or Legal Guardian)
Will you have daily access to a computer or laptop in the summer? (Other than your cellphone or school issued device) *
Do you have Wi-Fi access? (Other than your school hot spot) *
Do you have transportation to get to work? (Car, walk, bike, bus, etc.) *
If you do not have transportation, will you be willing to take the bus to work? *
( Note: Bus fare will be provided )
What days and times are you available? Check as many options that apply. *
8-11
11-2
2-5
NOT AVAILABLE
Monday
Tuesday
Wednesday
Thursday
Friday
We want to know more about YOU!  Please take your time and answer the questions honestly and thoughtfully. There is no right or wrong answer so feel comfortable to express yourself because…we want to hear more about YOU! After you answer each question, in addition, you can provide a video recording of your responses while telling us more about yourself.
What are some of your hobbies and interests? *
What language(s) do you speak? Please list all.
Why are you applying to this internship program? Please be as detailed as possible. *
List 3-5 qualities / characteristics about yourself that you are proud of and explain why you are proud? *
Describe a time, in detail, when you overcame a challenge. (Be sure to describe the challenge, why was it a challenge, what did you do to overcome it and what lesson did you learn?) *
We would love to see and hear from you! Record a :30 second video message telling us more about you! (optional)
(Record a video and upload it to one of the following platforms (IGTV, Facebook, YouTube, etc...) Make sure you provide us with the url link by copying and pasting it below!)
Congratulations, you’re almost done with your application! You should be proud of yourself! Read the following and if you agree, please click each box below.
I am a committed to attending all workshop sessions and all intern work hours for the entire period of June 28 – July 30. *
Required
 I understand that I will receive a stipend that will be disbursed. *
Required
I will participate in the program with respect for myself, other opinions and ideas. *
Required
I understand that sessions and work may be held online through the Zoom digital platform and/or in-person. *
Required
Type First and Last Name *
 (By entering your name below you agree that you have read everything carefully and agree).
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