PERSONAL INFORMATION
Name
Birthdate
School Year
Social Security Number
—Please choose an option—FreshmanSophomoreJuniorSeniorGraduate Student
Address
City
State
Zip Code
Home Telephone
Cell Phone
Email
AVAILABILITY
Start:
End:
Available Work Days
Interview Availability
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Select all that applyMondayTuesdayWednesdayThursdayFriday
Select all that applyOnlineTelephoneIn Person
EMERGENCY CONTACT INFORMATION
Contact #1 Name
Phone
Relationship
Contact #2 Name
Contact #3 Name
CAREER & EDUCATIONAL OBJECTIVES
What interested you to apply for an internship at Mechanical Rubber? What are your academic and/or educational goals for the future? Please list, in order of preference, occupations you want to pursue as future career goals.
EDUCATION
College
Year graduated (or anticipated)
What are your two favorite subjects in school? Explain skills learned in each. What extracurricular activities or clubs are you involved with? Special Skills / Expertise
JOB SKILLS
Identify your strongest work-related skills and explain why they are your strongest. Give examples of teamwork skills you use on a regular basis. Describe four personal management skills and give an example of how you use each skill in your daily life.
REFERENCES
Business
Years Known
Comments
Upload Resume if available (not required)
AUTHORIZATION
"I, the applicant, certify that the information given in and with this application is true and complete to the best of my knowledge and that it may be viewed by employers for the purpose of determining potential placement. "I agree to attend any safety courses or sessions required for individual programs or departments. I understand that my application does not guarantee employment."
Date:
Signature:
You will be required to sign this form in person, should you be called in for an interview.
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