Intern Form

City of Newport News Intern Application

CONTACT INFORMATION

First Name (Required)

Last Name (Required)

Middle Name

Address

City, State, Zip Code

Home Phone

Please include area code. Format: 999-999-9999

Cell Phone

Please include area code. Format: 999-999-9999

E-Mail Address (Required)

EDUCATION

Please indicate your current education status. If you are an Undergraduate Student or a Graduate Student, list the University and your Major.

Current Education Status

Area of Interest

University and Major

QUALIFICATIONS

List any courses relevant to the internship you are seeking:

Have you been employed during the past six months?

If yes, please complete Employer, Position, and Dates below:

Employer

Position

Dates

List any other paid or unpaid work experience as it relates to the internship you are seeking:

List other training, qualifications, and special interests (licenses, skills with machines, publications, memberships in professional or scientific societies):

AVAILABILITY/SCHEDULE REQUIREMENTS

Available from:

/ /

Number of hours required to fulfill education program requirements (if applicable):

Schedule availability/preference (list days and times):

ADDITIONAL INFORMATION

Have you ever been convicted of a crime, including DWI/DUI and reckless driving, but excluding minor traffic violations? A conviction does not automatically mean that you cannot be considered for an internship with the City.

If Yes, please give the charge, date and disposition below:

Charge, Date and Disposition

Are you currently employed by the City of Newport News?

Do you currently have any relatives working for the City of Newport News?

If yes, please list the relative's name, relationship and department below:

Relative's Name, Relationship and Department

If you are a current college student, does your degree program require an internship?

Please provide your current GPA:

You may attach an electronic version of your resume:

By clicking the SUBMIT button, I certify that the information given in response to the foregoing questions is true and correct and that I have not knowingly withheld or misrepresented any material fact herein or in my resume. Any false information given herein shall result in the immediate rejection of this application.

Thank you for your interest in the City of Newport News Internship Program!