Internship Application

 Internship Option of Interest (please indicate by name from the Internship Options flyer)
_________________________________________________________________________________
Is the requested internship for school credit or personal interest?____________________________
Name:______________________________________________ Date:________________________
Address:_____________________________________________
City_________________________________ State_______________________ Zip Code_________
Phone:(home/school)____________________________ (work)______________________________
(mobile)___________________________________ (fax)___________________________________
Email:____________________________________________________________________________
Computer Program Skills:____________________________________________________________
Languages(please specify speaking/reading/writing ability levels):___________________________
_________________________________________________________________________________
Other Skills:_______________________________________________________________________
_________________________________________________________________________________

EDUCATION

Current School(Name/Address):_______________________________________________________
_________________________________________________________________________________
City___________________________________ State___________________ Zip Code___________
Degree:____________ Major:__________________________ Minor:__________________________
Graduation Date:________________________ Current GPA:________________________________
School Actvities/Clubs/Associations___________________________________________________
_________________________________________________________________________________

VOLUNTEER/INTERN/WORK EXPERIENCE

Do you have any past experience in volunteering, community involvement, or political work?______
__________________________________________________________________________________
__________________________________________________________________________________
What volunteer work, if any, are you currently doing?_______________________________________
__________________________________________________________________________________
Have you had an internship in the past?_______ YES______ NO If yes, please describe
__________________________________________________________________________________
__________________________________________________________________________________
Do you have any previous work experience?______ YES ______ NO Please list job title and
description of duties:
__________________________________________________________________________________
__________________________________________________________________________________

SCHEDULING & TIME FRAMES

Summer 2009 Internships

200 hours are required, typically 20 hours a week for 10 weeks
Which time best suits your needs?

______(A) Wednesday, May 20th through Friday, July 31st.
OR
______(B) Wednesday, June 17th through Friday, August 28th.

Other Internships

150 Hours are required, with a schedule to be planned individually with each intern.
What time frame is best suitable for you? (Please check and circle Quarter or Semester)

______Fall Quarter or Semester
______Spring Quarter or Semester
______Winter Quarter or Semester

all time frames subject to approval by FWHC

Please provide any additional comments about scheduling and time frames here:
___________________________________________________________________________________
___________________________________________________________________________________

WHAT WE NEED FROM YOU

What we need from you as party of the internship application process:
______ Completed Application (this document)
______ Cover Letter
______ Resume
______ One Letter of Recommendation
______ Transcript (for informational purposes only)
______ Writing sample: 1-2 pages (single spaces) answering this question
"Why would I like to be an intern at the Feminist Women’s Health Center
and what it would mean to me?"

Please make sure all items are included when submitting your application

 WHAT YOU NEED FROM FWHC

 Please check off which of the following, if any, you will need from us:
______ Completed School Evaluation
______ Information Needed from FWHC for your Grant Application
______ One Reference Letter Upon Full Completion of Internship Requirements
______ Travel Stipend of $25 per week (10 weeks maximum) to offset costs of travel to
and from the Center. (There are limited stipends available. Availability is based upon financial need.)
_____ Other________________________________________________________________________

I do hereby attest that this application and other requested materials are complete and true to the best of my knowledge.

Signature___________________________________________ Date___________________________

 Thank you very much for your interest in the Feminist Women's Health Center's Internship Program. We look forward to talking with you soon.

Please mail completed application packet to: