Internship / Co-op Application

The Internship / Co-op application will be here.

Please correct the errors below.

Campus

Downtown
Southwest

Semester

Fall
Spring
Summer

Program

Co-op
Internship

Personal Info.

Full Name

Address

Zip

Work Phone

Mobile Phone

Date of Birth

Student ID

Emergency Contact

Emergency Phone

School Info.

Major

Advisor

Gpa

List two faculty recommendations. At least one should be your major.

Recommendation 1

Recommendation 2

Veteran?

Time basis and shifts you would accept

Full-time
Permanent
Evenings
Part-time
Temporary

Start Date

Do you have your own transportation?

By submitting this form, I authorize the JCTC CREW Center or it designated representative to disclose this information to prospective employers in conjunction with placement. I further authorize the JCC Office or its representative to have access to my academic records. I understand that no part of my academic records will be disclosed to a prospective employer other than information contained on this form, unless I approve such disclosure on a separate authorized form.

All applicants meeting the appropriate requirements and technical standards shall be considered equally for admission to a community college or an academic program thereof, regardless of race, color, religion, sex, marital status, national origin, age or disability.