MMYC Internship Program
LAYC/MARYLAND MULTICULTURAL YOUTH CENTERS
2015 Summer APPLICATION
Please include this in your application packet due by May 5th, 2015.
If you have any questions contact Jessica Cordero at [email protected] or
240.772.1010
Date:
First Name:
Middle
Initial:
Street Address:
City:
Home Phone:
Last Name:
Apt. #:
State:
Cell
Phone:
Age:
Date of Birth:
First and last name:
Relationship to Applicant:
Zip:
Email:
Gender:
Male
Female
Emergency Contact Information
Phone Number:
Transportation: Please indicate how you will get to your internship
 Public Transportation
 Car
 Bike
 Walk
Work Experience: Please list two employers (paid or volunteer)
Organization/Position
City, State, Zip
Phone # and Start/End
Supervisor
Dates
Name
 Other
Volunteer
Education
School Name:
City:
What grade are you in?:
GED: YES
Student ID # :
State:
Did you officially withdraw?
NO
Are you in College:
Zip:
YES
NO
1st year 2nd year 3rd year 4th year
If you have any questions contact Jessica Cordero at [email protected] or 240.772.1010
MMYC Internship Program
LAYC/MARYLAND MULTICULTURAL YOUTH CENTERS
2015 Summer APPLICATION
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Check the type of jobs that interest you the MOST
Working with Senior Citizens
 Working with Children

Working with
 Journalism /New

Nature/Environment
Reporting
Sports & Recreation
 Video Production

Animals
 Social Media
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


Receptionist /Front Desk
Arts and Crafts
Automotive
Fire Fighting /Law Enforcement

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 Computer/Information
Technology (IT)

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

Government Work
Culinary/Food Service
Construcion
Medical/Nursing

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

Office Work
Health Care/ Science
Theatre/Play /Dance
Organizing
paperwork
Electrical
Banking/Financial
Social Work
I’m open to anything
 Other, describe:
Do your work (circle one): Yes or No
Your Schedule
Do you have other family obligations(circle one):
Yes or No
Are your available weekends (circle one):
Yes or No
If you have a job or other commitments provided your schedule
Sunday
Start:
Monday
Start:
Tuesday
Start:
Wednesday Thursday
Start:
Start:
Friday
Start:
Saturday
Start:
End:
End:
End:
End:
End:
End:
End: