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Internship Inquiry Form

Please complete the application below.

If you have any questions, please reach out to Human Resources, WCHDHumRes@woodcountyohio.gov

1. Student Information

First Name

Last Name

Street

City

State

Zip

Email Address

Phone Number

Academic Information

Space Cell	Response
College/University	College/University: Response
Degree you are pursuing	Degree you are pursuing: Response
Major	Major: Response
Minor	Minor: Response
Specialization	Specialization: Response
Expected Graduation Date	Expected Graduation Date: Response
Cumulative GPA	Cumulative GPA: Response

2. Does your program require this internship? *This question is required.

3. How many hours/weeks are you required to complete?

3. Area of Interest (check all that apply) *This question is required.

4. When would you plan to start your internship? (month and year)

5. What days are you available to be in-person for your internship? *This question is required.

6. Our hours are typically 8:30am-4:30pm. What hours are you available for the days you specified? (Example: Monday available 8:30-3:00, Tuesday available 8:30-12:00) *This question is required.

7. Please upload a copy of your resume *This question is required.

File: {{filename}} delete

8. I certify that my responses to all of the questions in this application are true and complete to the best of my knowledge. I also certify that I am 18 years of age or older. *This question is required.

Clear

Signature of