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Internship Application

Position for Application

PART I: Background Information

DOB
Are you eligible to work in the United States?
Yes
No
Are you currently a student enrolled in an academic institution?
Yes
No
Will you be employed or interning at another location during the session you are applying for?
Yes
No
T-shirt Size
S
M
L
XL
What is your availability during a work week?
How did you learn about this interning oppurtunity at the Dialogue Institute? Check all that Apply:
Website
Google Search
Social Media
Career Fair
Referral
Other

PART II: Education and Certifications

Highest Level of Education
High School
Undergraduate
Graduate

Education

PART III: Reference

List two (2) of the following types: Professional, Academic, Extra-Curricular or Volunteer. Family members are excluded as references.

Reference #1

Reference #2

PART III: SIGNATURE

Read carefully and sign with your signature to affirm that you understand and agree to comply with this statement.

I certify that the information submitted in this application and its supporting documents is accurate and complete. I authorize my references and former employers, without liability, to make full responses to any inquiries in connection with this application for this internship. If offered a position and I accept, I agree to actively complete all assignments, participate in all programs, respect all participants (i.e., staff, peers, visitors, partners, and affiliates) and their property, and abide by the rules and policies of the organization throughout the duration of the program. I give my permission to use my photos and videos taken during my internship for any legal use, including but not limited to publicity, copyright purposes, advertising, web content, and social media. Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

Date
  • Insta
  • FB
  • YT
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