Navy Child and Youth Internship Program

Student Intern Application

PRIVACY ACT STATEMENT

 

1.  AUTHORITY:  10 U.S.C. 5013, Secretary of the Navy; 10 U.S.C. 1588, Authority to Accept Certain Voluntary Services; and E.O. 9397 (SSN).

 

2.  PRINCIPLE PURPOSES(S):  To select and place student interns; to produce all placement and travel documentation and reservations; to supervise and monitor performance of student interns; and to track overall program satisfaction and results.

 

3.  ROUTINE USES:  Used by command personnel and host installations to prepare documents and track overall program satisfaction.

 

4.  DISCLOSURE:  Voluntary.  However, failure to provide such information may result in our inability to prepare documents required for participation in and travel to internship location.

ELIGIBILITY  (requires a “yes” response for each of the following statements)

  Yes, I am a college senior or graduate student, or will have attained that status prior to the internship session for which I am applying.

  Yes, my major GPA is a 3.0 or higher.

  Yes, I will have completed all of my university internship participation prerequisites prior to the internship session for which I am applying.

  Yes, I am a United States Citizen.

Length of Internship: 

 

GENERAL INFORMATION

Last Name:

     

First Name:

     

Middle Name:

     

Date of Birth:

     

Gender:

U.S. Citizen:

CONTACT INFORMATION

Address:

     

City:

     

State:

  

Zip:

     

Contact Phone Number:

     

Contact E-mail Address:

     

UNIVERSITY INFORMATION

University:

     

Year in School:

Cumulative GPA:

    

Major:

     

Major GPA:

    

Minor:

     

University Advisor:

     

Phone:

     

E-mail:

     

PROGRAM AREA INFORMATION

Primary Internship Program Area Focus:

MOST RELEVANT WORK OR VOLUNTEER EXPERIENCE

1.  Business/Organization:

     

Dates of Service:

      to      

Primary Duties:

     

2.  Business/Organization:

     

Dates of Service:

      to      

Primary Duties:

     

3.  Business/Organization:

     

Dates of Service:

      to      

Primary Duties:

     

CERTIFICATIONS, ACCOMPLISHMENTS & AWARDS

Certifications with Expiration Dates:

     

Accomplishments:

     

Awards:

     

PROFESSIONAL REFERENCES (who can speak to your qualifications for this internship)

1.  Name:

     

Nature of Acquaintance:

     

Phone Number:

     

E-mail Address:

     

2.  Name:

     

Nature of Acquaintance:

     

Phone Number:

     

E-mail Address:

     

3.  Name:

     

Nature of Acquaintance:

     

Phone Number:

     

E-mail Address:

     

ACKNOWLEDGEMENTS & PERMISSIONS (requires a “yes” response for each of the following statements)

  Yes, the information I have provided above is complete and accurate.

  Yes, I grant Navy Fleet & Family Readiness Internship Program permission to contact my university advisor and professional references for the purpose of further determining my internship placement consideration.

  Yes, I grant Navy Fleet & Family Readiness Internship Program permission to run a background check on me as a final step in the internship placement process.

Applicant Signature:

 

Date:

 

NEXT STEPS

  Review this application for completeness and accuracy.

  Print this completed application form.

  Sign and date ACKNOWLEDGEMENTS & PERMISSIONS section above.

  Request an official copy of your university transcripts be mailed from the Registrar’s office to Navy Fleet & Family Readiness Internship Program address below.

  Write a cover letter to accompany your internship program application.

  Mail cover letter and this application to: 

 

COMMANDER NAVY INSTALLATIONS COMMAND NAVY FFR INTERNSHIP PROGRAM N947                    5720 INTEGRITY DRIVE BLDG 457                      MILLINGTON TN  38055-6540