eCampus Career Internship

Career Information Card

1. Name: ________________________ (first & last)

2. Birth Date:___________________

3. High School____________________

4. Phone numbers where you can be reached, include the area code:
Cell: ____________________
Home:___________________
Do You have FREE TEXTING?
May I TEXT you with class information?

5. Parent/Guardian Name: _______________________________

6. Phone Numbers of Parent/Guardian: Work: ___________ Cell:____________ Home:___________

7. I do not have time to shadow or intern in any other careers right now because of my work commitments. I
understand that it is my responsibility to contact you if I change my mind. TYPE YOUR NAME HERE if
this statement pertains to you:

8. Top 3 careers you are interested in learning more about because you are considering them after high school.

9. I would like to intern or job shadow at the following businesses? (These should relate to what you listed in #8.)

10. I am enrolled in this class during the following blocks:

11. Please give the name of the business you currently work, the address, and yoursupervisor name:

12. If you dont have a job, please tell me how you plan on earing the hours internship or volunteer activity?