Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Important Information to Note *

I am aware that this internship is unpaid. I have my own laptop to use with Microsoft software access, including Excel and Word. I understand that most of my internship will be in the Fort Worth office. I understand that this internship is not virtual only, but may include some virtual time.

Yes, I agree to the above statements

No

During which hours are you available for intern assignments? *

Select all that apply:

Weekday mornings

Weekday afternoons

Weekday evenings

Weekend mornings

Weekend afternoons

Weekend evenings

What days of the week are you available? *

Select all that apply:

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

Saturdays

Sundays

Is this internship for academic credit? *

Yes

No

School Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Advisor Name

First Name

Last Name

Advisor Phone

(###)

###

####

Emergency Contact *

First Name

Last Name

Emergency Contact Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone *

(###)

###

####

Signature *

By entering my name below and submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as an intern, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

First Name

Last Name

Date

MM

DD

YYYY