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Student Application for Internships
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Please read the following instructions before completing:
Review the Minimum Qualifications on the job announcement. If applying for more than one internship, a separate application is required for each.
How did you learn about this vacancy?
*
-- Select One --
Walk-in
Referred by City Employee
Patterson Irrigator
Modesto Bee
City of Patterson Website
Other
Title of Position
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Last Name
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First & Middle Name
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Address1
*
Address2
City
*
State
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Zip
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Driver's License:
Number
Issuing State
Expiration Date
Do you have a driver's license and use of a vehicle?
*
-- Select One --
Yes
No
License Only
Check One
*
-- Select One --
Freshman
Sophomore
Junior
Senior
Other
Semester
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-- Select One --
Fall
Winter
Spring
Summer
GPA
*
Graduation Date
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School Information:
College or University
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Address
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Contact
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Phone Number
*
Employer
Address
From
To
Supervisor Name and Title
Description of Duties
Employer
Address
From
To
Supervisor's Name & Title
Description of Duties
Employer
Address
From
To
Supervisor's Name & Title
Description of Duties
Skills and Training
Skills, Abilities and Interests:
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Computer:
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What foreign languages do you speak and understand?
Other valid licesnes and/or certificates you hold that relate to your qualifications for this position:
When are you available to start a work-study/internship?
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Approximate hours per week:
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What are your objectives for participating in an internship program?
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What kinds of work would you like to do during your internship?
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Internship Preference
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Generalist
Specialist
Specialist - area of Interest
If a stipend is not offered, would you be able to accept an internship on a volunteer basis?
*
What, if any, limitations do you have that may have a bearing on your placement?
Certificate of Application
I certify that all of the statements made on this application are true, complete and correct to the best of my knowledge and belief and are made in good faith. I understand that any false or omitted information, which I may or may not give, may result in either denial of internship or termination. I authorize the City of Patterson to investigate all statements on this application, including work references. I acknowledge that this internship is conditional upon successful completion of a physical examination and/or drug screening test, and a background check as part of the City's pre-employment policy.
Certify
*
I certify that I have read, understand, and agree to the above.
Consent
It is the City's policy, as a part of the selection process, to contact your former employers for employment-related reference information. If you refuse to authorize us to contact all but your present employer, you will be disqualified from consideration for the position. Employers will be contacted only if you have met all other qualifications and you are actually being considered for employment.
Consent
*
I hereby authorize my former employers to release employment-related information to the City of Patterson.
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