Student Application to Participate in a BCCHS Internship - Due by February 24th
 An application to participate in a Birmingham Sponsored Internship
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Email *
Student Last Name, First Name
Grade Level
*
Date of Birth
MM
/
DD
/
YYYY
Age
Address - Street Number and Name
Address - City and Zip Code
Student Phone Number (mobile)
Student Email
Emergency Contact  - Full Name (Must be over 18 yrs)
Emergency Contact - Relationship
Emergency Contact - Phone number
Internship Area of Interest
Current CTE program
Current GPA (Grade Point Average)
Which days are you available to work in the internship? Check all that apply.
Which times are you available to work in the internship? - check all that apply
How will you get to the internship site? What transportation is available to you?
Why are you interested in participating in an internship?
List any AP, college, pathway or career courses or workshops in which you have participated.
List any work experience you have. Include previous internships or volunteering experience. Please include dates, your job title or role, and duties you performed.
List any special skills or qualifications you have. Are you bilingual? Do you have experience using specific software (Adobe, Microsoft Office, Autocad, etc) or do you have experience using special equipment in your classes or at prior jobs or internships?
Describe some of your personal and professional or educational goals.
List extracurricular activities in which you have participated (clubs, sports, hobbies, etc)
List any honors or achievements or awards you have earned.
List the job skills you would like to learn in this internship (sales, customer service, financial skills, photo editing, IT Cybersecurity skills, etc)
Please list the first and last name and phone/ email contact of an adult who can be a reference for you (teacher, coach, family friend)
What else would you like us to know about you?
A copy of your responses will be emailed to the address you provided.
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