bridge Internship PROGRAMApply to become a Bridge intern PERSONAL INFORMATION Name * First Name Last Name Date of Birth * MM DD YYYY Phone * (###) ### #### Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country SCHOOL INFORMATION High School * Fairhope Spanish Fort Daphne Graduation Year * Are you eligible for co - op through your school? * Yes No School Counselor's Name * School Counselor's Email * Career Interests & Skills Which industries are you most interested in? * Check all that apply Shipbuilding & Maritime Manufacturing & Engineering Healthcare & Medical Support Business & Finance Technology & IT Others Have you taken any related courses or certifications? * Yes No If yes, please list Do you have prior work or volunteer experience? * Yes No If yes, please describe What skills do you hope to gain from this internship? * Availability & Commitment Are you able to commit to a year - long internship (10 - 15 hours per week)? * Yes No Do you have reliable transportation to and from your internship site? * Yes No Why do you want to participate in the Bridge internship program? * Please describe. What are your career goals after high school? * Please describe. Additional Information Do you require any accommodations to participate in the program? * Yes No If yes, please explain Emergency Contact Name * First Name Last Name Emergency Contact Phone * (###) ### #### Relationship to you * Parent/Guardian Others Thank you for your submission! A member of the Eastern Shore Bridge team will contact you soon about your application.
