Dawn Learning Center | Local Internship Application

First Name

Middle Name

Last Name

Address

Street Address

Apt, Suite, Bldg.

(optional)

City

State / Province / Region

Postal / Zip Code

Country

Phone Number

Please enter your phone number formatted as (XXX)-XXX-XXXX ext.XXXX (optional)

Is this your:

Home PhoneCell PhoneWork Phone

Please upload your resume or CV

School

Degree/Program

Concentration(s)

Minor(s)

GPA

Please format as: XXX out of XXX

Anticipated Graduation

Please format as: mm/yyyy

Certifications

Please list the three most relevant certifications that you hold along with the date you received them.

Date Received

Please format as: mm/dd/yyyy

Certification 2

Date Received

Certification 3

Date Received

Please format as: mm/dd/yyyy

Company 1 Name

Please list your 3 most recent or relevant employers

Position Held

Summary of tasks/responsibilites

Duration

Please include the start and end dates, and format as: mm/yyyy – mm/yyyy. If you are currently employed here then write start date to present and format as: mm/yyyy – present.

Supervisor Name

Supervisor Title

Supervisor Phone Number

Please enter your phone number formatted as (XXX)-XXX-XXXX ext.XXXX (optional)

Supervisor Email

(optional)

Company 2 Name

Position Held

Summary of tasks/responsibilities

Duration

Please include the start and end dates, and format as: mm/yyyy – mm/yyyy. If you are currently employed here then write start date to present and format as: mm/yyyy – present.

Supervisor Name

Supervisor Title

Supervisor Phone Number

Please enter your phone number formatted as (XXX)-XXX-XXXX ext.XXXX (optional)

Supervisor Email

(optional)

Company 3 Name

Position Held

Summary of tasks/responsibilities

Duration

Supervisor Name

Supervisor Title

Supervisor Phone Number

Please enter your phone number formatted as (XXX)-XXX-XXXX ext.XXXX (optional)

Supervisor Email

(optional)

Reference 1 Name

Please list 2 references

Reference Phone Number

Please enter your phone number formatted as (XXX)-XXX-XXXX ext.XXXX (optional)

Reference Email

Relation to Applicant

Reference 2 Name

Reference Phone Number

Please enter your phone number formatted as (XXX)-XXX-XXXX ext.XXXX (optional)

Reference Email

Relation to Applicant

Follow Up Questions

Would you like to be contacted for employment purposes in the future?

YesNo

Verification

Please enter any two digits