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Internship Application

    PERSONAL INFORMATION

    NameBirthdateSchool Year Social Security Number
    AddressCityStateZip Code
    Home TelephoneCell PhoneEmail

    AVAILABILITY

    Start: End:Available Work DaysInterview Availability
    ctrl+shift for multiple selections

    EMERGENCY CONTACT INFORMATION

    Contact #1 NamePhoneRelationship
    Contact #2 NamePhoneRelationship
    Contact #3 NamePhoneRelationship

    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


    CollegeYear 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

    Name
    Address
    Phone
    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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