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Home-Based Internship Application (All fields are required)

 

CONTACT INFORMATION

Full Name
Street, Address*
Include city and state
 
State Zip Code
E-mail
Phone number
Alternate phone
Birthdate

Are you active on Facebook? If so, please accept our friend request from Positive Media Interns

  no

 

PROFESSIONAL INFORMATION

Highest level of education completed. Please check all that apply

High School

College

Graduate School

 

 

Major

Degree

 

Work history. Please describe your past 5 year work history




Indicate the approximate number of hours you estimate being able to work per week




 

Please select areas in which you have proficiency:









How fast do you type?    words per minute

 

Foreign Language Skills

Language 




 

Language 




 

EXTRACURRICULARS

Family

Please describe your relationship with your family. How have they influenced your development? Who has shaped you the most? What kind of support (emotional, spiritual, etc.) do they provide for you?. Maximum 150 words.

 

Personal Development

Describe a time when you overcame an obstacle that helped form who you currently are. Maximum 150 words.

_______________________________________________________________________________________

All fields are required


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