Last Name

Middle Name

First Name

Address

City

State

Zip

County

Phone Number

Email Address

School

School Name

General Questions

Is this internship required for your degree program?

• Yes
• No

If so, what are your school’s internship requirements (hours per semester required, etc.)?

List school contact information (coordinator's name, title, phone number and/or email for contact purposes)

When is your anticipated start date?

When is your anticipated end date?

How many hours per week?

Days/Times you are available?

What is your area of study or degree will you be rewarded?

What is your anticipated graduation date?

What classes/courses are you currently taking?

Please list any relevant work or volunteer experience.

Why do you desire an internship with Catawba County?

What is your current knowledge about Catawba County and our services?

What do you hope to learn during your internship experience?

List 2 things you do well at the moment.

List 2 things you would like to learn to do better.

What are your career plans for the future?

Today's Date

Submit