Internship Application

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Date:
Application For:
   
How did you hear about this job:

Personal Information

First Name:
Last Name:
Middel Initial:
Student ID Number:
Street Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Email:

Educational History

Graduated From Highschool? Yes No GED
High School Name:
Street Address:
City:
State:
How many semesters have you
attended Palomar College?:
Units currently enrolled in:
What is your major?:
Have you attended any College, University or Trade School other than Palomar College?: Yes No
College, University, Trade School Address:
City:
State:
Degree/Certificate:
College, University, Trade School Address:
City:
State:
Degree/Certificate:

Experience

What RTV courses have you completed?:
What RTV courses are you currently enrolled in?:
Do you have any other production related experience?:
Why are you interested in interning with us?:

Current and past employment

Start Date:
End Date:
Employer:
Address:
Phone:
Supervisor:
Job Title:
Describe duties and responsibilities:
Start Date:
End Date:
Employer:
Address:
Phone:
Supervisor:
Job Title:
Describe duties and responsibilities:
May we contact your present
and past employers?:
Yes No

Personal References

(only one may be relatives)

Personal Reference 1

Name:
City:
State:
Phone:
Relationship:

Personal Reference 2

Name:
City:
State:
Phone:
Relationship:

Personal Reference 3

Name:
City:
State:
Phone:
Relationship:

Days and hours available to work

Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Do you have any physical condition that may limit your ability to perform the duties of the position applied for?
If yes, please explain:

Additional Information or comments:

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