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Email us at WATERstaff@hers.com with your mailing address to receive a complimentary copy of our newsletter, WATERwheel!
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WATER INTERNSHIP APPLICATIONCheck List: 1. Personal DataName:____________________________________________________________________________________ Current Address:___________________________________________________________________________ Current Telephone Number: ____________________________________________________ Permanent Address:_________________________________________________________________________ Permanent Telephone Number: __________________________________________________ Fax: _______________________________ E-mail:__________________________________ Please list the dates for which you are considering an
internship (6 weeks minimum, nine months maximum): Please list any office and/or computer skills you may have:_________________________________________________________________________ Languages Spoken:___________________________________________________________ Any other skills you would like to mention:__________________________________________ __________________________________________________________________________________________ Extra Curricular and Community Activities:_________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ 2. Work ExperienceList all work experiences, beginning with your most recent employer. Attach additional sheets if needed. 1) Dates of Employment:_____________________________________________________________________ Employer:_________________________________________________________________________________ Address:__________________________________________________________________________________ Telephone Number: __________________________________________________________ Title/Duties:_______________________________________________________________________________ 2) Dates of Employment:_____________________________________________________________________ Employer:_________________________________________________________________________________ Address:__________________________________________________________________________________ Telephone Number: __________________________________________________________ Title/Duties:_______________________________________________________________________________ 3) Dates of Employment:_____________________________________________________________________ Employer: _________________________________________________________________________________ Address:___________________________________________________________________________________ Telephone Number: __________________________________________________________ Title/duties: ________________________________________________________________________________ 3. Institutional Information (if applicable)College/University:___________________________________________________________________________ Major:_____________________________________________________________________________________ Faculty Advisor:__________________________________ Telephone: __________________ Academic Credit Arrangements ___________________________________________________________________________________________ ___________________________________________________________________________________________ Faculty Advisor Agreement (if applicable):I endorse this student's candidacy for an Internship at WATER. I acknowledge that I am the Faculty Advisor for this student for the duration of this program and that I will receive all evaluations for this student. Name:_______________________________________________________________________________________ Address:_____________________________________________________________________________________ Telephone Number: ____________________E-Mail:_________________________________ Signature______________________________________ Date___________________________________________ 4. EssayPlease include a typewritten essay which describes: 1) Your background and related experience; and 2) Your overall personal goals for the internship, including any issues or concerns on which you wish to work while at WATER. Please limit your essay to two double-spaced type-written pages. 5. Emergency InformationEmergency Contact Person: Name:_______________________________________________________________________________________ Address:_____________________________________________________________________________________ Telephone Number: Day ________________________ Night __________________________ Fax: ___________________E-mail: _____________________________________________ 6. Internship AgreementI understand that the Internship Application, plus all supporting materials submitted to WATER, will not be returned or transferred to other institutions or potential employers. I certify that the information provided is complete and accurate. I understand that housing, meals, travel and miscellaneous expenses will be my responsibility. Signature_______________________________________ Date__________________________________________ Please submit all application materials to: WATER |
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