EHSI Online Information Form 2020
Please fill out each section completely and accurately!
Be sure to hit SUBMIT at the bottom
First Name *
Last Name *
Select one (optional)
Column 1
Male
Female
Clear selection
High School Name *
Student Email Address *
The one you use and check often! And will use in the future
Student Cell Phone Number *
please put spaces not dashes
Student ID Number *
Student Birth Date *
show as month/day/year
MM
/
DD
/
YYYY
Home Address *
City *
Capitalize
Zip Code *
Home Phone Number *
Please use spaces not dashes
Counselor Name *
Semester Preference
Please Note:  Summer Internships are only available in certain career fields
Which semester do you prefer to complete your internship? *
Please think about timing for sports, extracurricular activities, music, theater, transportation etc.
Career Interest
Internship Area of Interest *
Please select your FIRST choice for internship placement
Internship Area of Interest *
Please select your SECOND choice for internship placement
If you selected "Other" from the categories above, please describe!
What industry are you interested in? Please keep it to 5 words
Other
How many classes do you anticipate having during the semester of your internship? *
NOT counting the internship!
Will you have access to a car to get to and from your internship? *
Reliable transportation is a REQUIREMENT of this program!
How did you learn about Executive High School Internship (EHSI)? (Check all that apply)
Parent/Guardian Information
Parent 1 Name *
Parent 1 Phone Number *
Parent 1 Email Address *
Parent 1 Occupation
Parent 1 Place of Employment
Parent 2 Name
Parent 2 Email
Parent 2 Occupation
Parent 2 Place of Employment
Check that you have created your Adobe Spark Video *
Copy and Paste the Shareable Unlisted URL from your Adobe Spark Video.  This is a required part of the application.
BE SURE TO HIT SUBMIT AT THE BOTTOM OF THE FORM WHEN YOU ARE DONE
nothing is saved until you SUBMIT
Thank you for taking the time to complete this form. We will be in touch by email to schedule an interview if you have been selected.
For Questions please contact Ms. Usher at 303-982-8539 or execintern@jeffco.k12.co.us
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