Application for Internship 2009-2010

Name:  ______________________________________________________

Address:  ____________________________________________________

Phone #:  __________________  Email:  _________________________

Please answer the following questions and attach additional sheets if necessary:

What year do you plan to graduate high school?  _______________________

What school do you attend?  ___________________________________________

What do you plan on majoring in?  _____________________________________

Where do you plan to attend college?  _________________________________

Why are you interested in applying for this internship?

What skills do you have that would be beneficial for an internship with TASC?

Please list three references (non-relatives)

Name: __________________________ Relationship:  ____________ Phone:____________________

Name: __________________________ Relationship:  ____________ Phone:____________________

Name: __________________________ Relationship:  ____________ Phone:____________________

The Teen Action and Support Center will be reviewing applications and scheduling interviews for applicants the last week of September.