School Year Intern Explainer Program Application

By completing this application you have agreed that the responses are your own words and thoughts.

Today's Date 12/08/2016
*First Name
*Last Name
*Address: Street
Apt #
*Zip Code
*Phone Number
Cell Phone
*Date of Birth MM/DD/YYYY
*E-mail Address

Parent/Guardian Information

*Parent/Guardian Name
*Their relation to you
*Daytime Number
Cell Phone
Email Address

School Information

*Current Middle or High School
School Address
*Councilor/Advisor/Teacher Name
*Contact Email
*Contact Phone #
*Your Projected High School Graduation Date (Month/Year)

Please check all the days and shifts you are available to volunteer

Saturdays: 9:30am - 2:00pm
Saturdays: 1:30pm - 6:00pm
Sundays: 9:30am - 2:00pm
Sundays: 1:30pm - 6:00pm

The following questions provide an opportunity for you to express your interests to us. Please take time to answer all the questions thoughtfully and completely. (All fill in writing fields are limited to 900 characters.)

*1. How did you find out about the Intern Explainer Program?

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*2. Why do want to join the program?

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*3. What are your interests? Favorite subjects? Extra-curricular activities?

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*4. Describe an interesting experience you have had within an area of science.

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*5. What type of experiences have you had interacting with or working with children or teaching?

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*6. Have you ever had a job or internship before? What did you do? What do you see yourself doing in five years?

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