Internship Application

Program Participant Information

First Name

Last Name

Suffix

Preferred Name

Pronouns?

Pronouns - If other:

Program Participant Contact Information

Street Address

City

State

Zip/Postal Code

County

Personal Email Address

Preferred Phone

Mobile Phone

Home Phone

Work Phone

Other Phone

Additional Participant Information

Have you attended BAYCAT before?

If Yes, what program(s) have you participated in and for which year(s)?

Birthdate

Gender

Gender - Other

Ethnicity

Ethnicity - Other

How did you hear about BAYCAT?

Social Media Platform

Social Media - Other

How did you hear about BAYCAT? - Other

Please share details like the name of the person or organization that referred you or which event or place or platform where you learned about BAYCAT.

Household Information

Number of Persons in your Family

Annual Household Income

Internship Information

What is your availability for an internship?

What is your highest level of education?

Are you currently in school?

Have you ever had a job?

If yes, please describe your job experience.

Are you currently employed?

Do you have a LinkedIn or social media profile? If yes, please provide the URL.

Do you have any friends or family members who have participated in the internship?

How do you see yourself using media to impact society?

Why do you want to participate in the BAYCAT Internship?

Contact Information