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Internship Application 09 10
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  • 1. WATKINS MILL HIGH SCHOOL Student Internship Program Application Packet Mrs. Vivian T. Griffin, Intern Coordinator Vivian_Griffin@mcpsmd.org
  • 2. WATKINS MILL HIGH SCHOOL Montgomery County Public Schools 10301 Apple Ridge Road Gaithersburg, Maryland 20879 ACADEMIC INTERNSHIP PROGRAM APPLICATION FOR 2009-2010 Name________________________________________SS#____________________Grade_____ (Last) (First) (Middle) Address_______________________________________________________________________ (Street) (Apt. No) (City) (Zip) _____________________________________________________________________________ _ (Home phone) (e-mail address) If not a U.S. citizen, do you have a green card? YES NO Date of Birth: ____________ Of what country are you a citizen?____________________ Full Name of Parent or Guardian___________________________________________________ (Last) (First) Address: ____________________________________________________________________ (Street) (Apt. No) (City) (state) (Zip) (Work phone) ___________________ (Parent E-mail address) ______________________ Emergency Contact_________________________ Emergency Phone No. ________________ High School: ___________________________________ Current GPA:____________________ Counselor: ________________________ Signature: _________________________________ (please print) If you are selected to be an intern, you must be able to provide your own transportation to your internship site. Does this pose a problem? Why? _____________________________________________________________________________ _ _____________________________________________________________________________ _ Circle your choice: SINGLE PERIOD DOUBLE PERIOD TRIPLE PERIOD
  • 3. (Hospitality Management Completers Must have a minimum of 2.0 credits of internship) All internships are two semesters unless prior permission is granted. (Most professionals do not want to train an intern for only one semester.) Have you had salaried work in the hospitality industry after school or during the summer? _________________________________ Are your currently employed? YES NO Employer:______________________________________________Phone #:_________________ Name of Supervisor _______________________________________________________________ Employer Address ________________________________________________________________ Describe your job duties _______________________________________________________________ PreviousEmployer:_____________________________________________Phone #:________________ Name of Supervisor _______________________________________________________________ Employer Address ________________________________________________________________ Describe your job duties _______________________________________________________________ Why did you leave this job? __________________________________________________________ Evaluate your academic performance (circle one): Excellent Good Fair Poor Current GPA: _______ Comments: _____________________________________________________________________ _____________________________________________________________________________________ Do you have any after-school obligations (for example, family obligations, sports, music lessons) If so, please list days and hours of the week when these occur _____________________________________________________________________________________ _____________________________________________________________________________________ Evaluate your school attendance: (circle one) Excellent Good Fair Poor Number of Days Absent previous semester__________________________________________________ Do you have any health problems that may affect your attendance? _______________________________ What type of career would you like to learn about?____________________________________________ Where would you like to work? _______________________________________________________
  • 4. SIGNATURE OF APPLICANT_____________________________________ Date_________________