Human Resources · 7 Bishop Street · Framingham, MA · 01702 · FAX 508-879-2248

Internship Application

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Name: Last: ___________________________________ First: ______________________________

Address: __________________________________________________________________________

Town: _________________________ State: ________________ Zip Code: ________________

Phone # ________________________________ Cell # _____________________________________

Work # ______________________ Email: ______________________________________________

1. Where did you hear about South Middlesex Opportunity Council Internship Opportunities?
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2. Are you currently employed? Yes No

Who is your employer? _____________________________________________________________

3. Are you a full-time Student? Yes No

3. High School/College/Graduate School: ________________________________________________

4. Guidance Counselor/Professor/Training Director: ________________________________________

5. Class Internship is for? (if any) ______________________________________________________

6. Dates of Internship: Start Date: ___________________ End Date: _______________________

7. What is your major? ________________________________________________________________

8. What are your career goals? _________________________________________________________

9. Do you have any other activities that might conflict with this internship? If yes, please explain:

________________________________________________________________________________

_________________________________________________________________________________
5. Please indicate how frequently you are available to intern?

Once a week More than once a week

Once a month Periodically on request

6. What time/days are you available to Intern?

MON TUE WED THUR FRI SAT SUN

AM
PM
EVE

Hours/
Available

7. Are you licensed to drive in Massachusetts? Yes No

8. Do you have a car available to you? Yes No

9. Are there any limitations to your ability to drive a motor vehicle? Yes No
Please explain if yes:
_________________________________________________________________________________

_________________________________________________________________________________

10. Do you speak or write any other languages, other than English, Fluently? Yes No
If yes, which? ___________________________________________________________________

11. Do you have a resume? Yes (If yes, please attach a copy.) No

12. List three words that describe your overall attitude: ______________________________________

________________________________________________________________________________

_____________________________ ________________________
Signature Date

We are an Equal Opportunity Employer. We consider applications for all positions without regard to
age, race ,color, religion, natural origin., sex, sexual orientation, military status, disability, or any other
legally protected status pursuant to Massachusetts Fair Employment Practices Act, and other relevant
federal, state and local laws. Those applicants requiring reasonable accommodation to the application
and/or interview process should notify Human Resources.