Internship Application - Goodwill of Northwest NC

Date*

Name*

First Middle Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Email*

This should be an email address to which only you have access and that you check frequently as it may be used to contact you so that you can complete additional information relevant to your application.

With whom did you interview for this internship opportunity?

Please provide the name of the school at which you are enrolled and program through which you are interning:*

Please provide internship location:*

Please provide internship supervisor name:*

Please provide internship supervisor email, if known:

Have you volunteered or interned for or been employed by Goodwill Industries of Northwest NC before?*

Yes

If yes, please give dates and department/area:*

Are any of your family members employed by Goodwill Industries of Northwest NC?*

Yes

On what date would you be available to start interning?*

What days of the week are you available to volunteer?*

Areas of interest (check all that apply):*

Please summarize your skills and abilities:*

Professional References

Please list at least two individuals who have worked or volunteered with you and have knowledge of your skills. (No relatives please.)

Professional Reference 1: Name*

First Last

Professional Reference 1: Phone*

Professional Reference 1: Email*

Professional Reference 1: Relationship to You*

Professional Reference 2: Name*

First Last

Professional Reference 2: Phone*

Professional Reference 2: Email*

Professional Reference 2: Relationship to You*

Professional Reference 3: Name

First Last

Professional Reference 3: Phone

Professional Reference 3: Email

Professional Reference 3: Relationship to You

Why do you feel motivated to intern with Goodwill and what do you hope to gain from the experience?*

How did you hear about Goodwill's intern program?*

Emergency Contact Information

Emergency Contact Name*

First Last

Emergency Contact Phone*

Emergency Contact Email*

Emergency Contact Relationship to You*

Applicant's Statement

I affirm that the facts set forth are true and complete. I understand that if I am accepted as a volunteer or intern, any false statements, omissions, or other representations made by me may result in my removal from the intern volunteer program. Goodwill is not obligated to provide a placement, nor are you obligated to accept the opportunity offered. All applications are held for 90 days.

Please check the box to indicate that you have read the applicant's statement above and agree to its terms.*

I agree to the terms of the Applicant's Statement.

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