RCHS Internship Application Complete this form to apply for an internship. Questions? Contact [email protected] Personal InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Phone*Native Language Other Languages Spoken Internship InfoWhy are you seeking an internship?In what fields are you interested in working at RCHS? What skills do you have that will help you succeed?Please provide a brief autobiography.EducationHigh School* 1 2 3 4 Click last year completedSchool* College 1 2 3 4 Click last year completedSchool Major Graduate School 1 2 3 4 Click last year completedSchool Major Instructor's InformationRequired if applying for an internship for credit or as part of course work.Supervising Profession or Teacher School Email PhoneEmployment and Volunteer HistoryCurrent Employment Status* Full time Part time Retired Unemployed Student Current Employer (if applicable) Position DutiesHave you ever volunteered?* Yes No If yes, where? Title/Duties there:AvailabilityI am applying for: Summer internship (8-10 weeks) Fall semester internship (8-10 weeks) Spring semester internship (8-10 weeks) Limited experience internship (No more than six weeks) Long tern internship (Six months to one year) Are you available to work full-time or part-time? Full Time Part Time Internship DurationPlease estimate the start and end dates of your internship Hours needed in totalEmergency ContactName* Daytime Phone*Relationship* Evening/Cell Phone*Signature and DisclaimerPlease carefully read the statements below and sign to complete your application: I certify that my answers are true and complete to the best of my knowledge. I understand that any false information or significant omissions will disqualify me from further consideration, and will be justification for my dismissal from the Rock County Historical Society Intern Program. I authorize the Rock County Historical Society to perform a background check based on the personal data I have provided above. I understand that if I elect to withhold my authorization, that my application will be considered incomplete. Name* First Last Date* MM slash DD slash YYYY Parent/Guardian Name First Last (If applicant is under the age of 18 at the time of application)Date MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.