Harney Internship Student Application : Harney Internship Program : Youth Changing The Community Collaborative : Collaboratives : High Desert Partnership

Name

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Last Name *

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Address

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Mailing Address

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Email (Required)

Year In School (Required)

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At least 16 years old? Yes or no. (Required)

Parent or Guardian Name

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Last Name *

Internship of Interest (Required)

If you checked Other for Internship of Interest please describe this internship interest or name the business you are interested in interning with

Days available

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Skills you feel will assist you in an internship: (Required)

Resume or Letter Introducing Yourself

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Student signature

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Last Name *

Parent or Guardian signature

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Phone

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Email

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