2020-21 Urban Alliance Virginia High School Internship Preparatory Program (HIPP) Application

Application Instructions
1. Please carefully read the instructions before submitting your application. 

2. In order for your application to be fully processed, we will need your counselor form AND your parent consent form. The parent form should be printed, signed and returned to Urban Alliance. The counselor form will be sent directly to the counselor listed on your application.

3. You don't have to finish the application in one session. You can save & return at a later time.

Please contact the Program Coordinator, Madison Cilluffo with any questions at mcilluffo@theurbanalliance.org and/or 571-612-0781.

Please note the following application deadline: June 30, 2020 at 11:59PM
Contact Information









Include unit number if applicable.






This information will not be shared with anyone outside Urban Alliance and will be kept confidential. The National Student Clearinghouse provides college attendance information based on SS#.  This helps us know if / where you attend college in the future.  This information also tells us if Urban Alliance helps students go to college.











Parent/Guardian Contact Information







Additional Emergency Contact





About Your School













Previous Employment and Career Interests




$

Additional Information




Additional Information




Forms Required
In order for your application to be fully processed, we will need your counselor form AND your parent consent form. The parent form should be printed, signed and returned to Urban Alliance. The counselor form will be sent directly to the counselor listed on your application.

Parent Consent Form

You can upload a signed copy of the parent consent form below, or email it to

Madison Cilluffo at mcilluffo@theurbanalliance.org.

Conditions for Acceptance
Please read the following statements carefully as they constitute conditions for your acceptance as an Urban Alliance Intern:
Once you press "Submit", you will no longer have access to the application.

Please send follow-up questions and documents to virginiaapplication@theurbanalliance.org.