CALIFORNIA FACULTY ASSOCIATION

TIM SAMPSON MEMORIAL STUDENT INTERNSHIP

APPLICATION

 

 

 

PLEASE PRINT THE FOLLOWING INFORMATION

 

NAME:  _________________________________________________________________________

                        Last                                          First                                         M.I.

 

 

ADDRESS:  ______________________________________________________________________

                                    Street                                        City                              Zip Code

 

HOME PHONE:  (_____)_______-_______           SOCIAL SECURITY (SID):  ________-_________-________

 

CELL PHONE: (______)_______-_______           E-MAIL: ____________________________________________

 

CLASS LEVEL:  ______________    MAJOR: ___________________    OVERALL GPA: ___________________

 

 

WHAT IS YOUR EXPECTED GRADUATION DATE? ________________________________________________

 

 

DO YOU HAVE ANOTHER JOB? ___YES___NO; IF YES, HOW MANY HOURS? ___________ AND

WHAT DO YOU DO? ____________________________________________________________________________

 

 

CAN YOU SPEAK ANY LANGUAGE OTHER THAN ENLISH FLUENTLY?

YES___ NO ___ IF YES, SPECIFY LANGUAGE (S): _________________________________________________

 

 

YOU MAY NEED TO TRAVEL THROUGHOUT CALIFORNIA (EXPENSES WILL BE PAID BY CFA), WILL YOU BE ABLE TO DO THAT? ____YES____NO; IF NO, PLEASE EXPLAIN

 

________________________________________________________________________________________________

 

________________________________________________________________________________________________

 

________________________________________________________________________________________________

 

DO YOU FEEL COMFORTABLE DOING PUBLIC SPEAKING/CLASS PRESENTATIONS?  YES___ NO___

 

WOULD YOU BE AVAILABLE TO DO STUDENT OUTREACH IN THE EVENINGS?             YES___NO___

 

IN CASE YOU GET THE INTERNSHIP CAN YOU START RIGHT AWAY?                           YES___ NO___

 

IN CASE YOU GET THE INTERNSHIP CAN YOU COMMIT AT LEAST ONE YEAR TO THIS INTERNSHIP?                                                                                                                                           YES___ NO___

1.  Describe your familiarity with the campus and student organizations?  Also include a list of student organizations you are a member of.

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2.  Describe briefly any experience you have had with the California Faculty Association (CFA) (When/Where).

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3.  List jobs, classes, internships, or volunteer experience you have had which is related to the internship you are applying for.

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

 

4.  Briefly explain what you hope to get out of this internship.

________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5.  Please write a short paragraph about yourself, describing your interests, personal characteristics, and goals as they relate to this internship.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

NOTE:  PLEASE ATTACH AN UPDATED COPY OF YOUR RESUME, AND TWO INDIVIDUALS WHO CAN SERVE AS YOUR REFERENCE.

 

 

 

 

 

 

 

 

APPLICANTŐS SIGNATURE ___________________________ DATE: _____________________