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Navy Child and
Youth Internship Program
Student Intern Application
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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.
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ELIGIBILITY (requires a “yes” response for each of the
following statements)
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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.
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Length of Internship:
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GENERAL INFORMATION
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Last Name:
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First Name:
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Middle Name:
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Date of Birth:
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Gender:
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U.S. Citizen:
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CONTACT INFORMATION
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Address:
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City:
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State:
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Zip:
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Contact Phone Number:
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Contact E-mail Address:
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UNIVERSITY INFORMATION
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University:
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Year in School:
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Cumulative GPA:
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Major:
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Major GPA:
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Minor:
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University Advisor:
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Phone:
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E-mail:
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PROGRAM AREA INFORMATION
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Primary Internship Program Area Focus:
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MOST RELEVANT WORK OR VOLUNTEER EXPERIENCE
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1.
Business/Organization:
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Dates of Service:
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to
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Primary Duties:
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2.
Business/Organization:
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Dates of Service:
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to
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Primary Duties:
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3.
Business/Organization:
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Dates of Service:
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to
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Primary Duties:
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CERTIFICATIONS, ACCOMPLISHMENTS &
AWARDS
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Certifications with Expiration Dates:
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Accomplishments:
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Awards:
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PROFESSIONAL REFERENCES (who can speak to
your qualifications for this internship)
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1. Name:
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Nature of Acquaintance:
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Phone Number:
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E-mail Address:
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2.
Name:
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Nature of Acquaintance:
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Phone Number:
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E-mail Address:
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3.
Name:
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Nature of Acquaintance:
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Phone Number:
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E-mail Address:
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ACKNOWLEDGEMENTS & PERMISSIONS (requires a “yes”
response for each of the following statements)
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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.
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Applicant Signature:
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Date:
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NEXT STEPS
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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:
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COMMANDER NAVY INSTALLATIONS COMMAND NAVY
FFR INTERNSHIP PROGRAM N947
5720 INTEGRITY DRIVE BLDG 457 MILLINGTON TN 38055-6540
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