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NAME
FIRST
LAST
DATE OF BIRTH
MM slash DD slash YYYY
WHAT BUSINESS ARE YOU APPLYING TO INTERN FOR?
STUDENT'S ADDRESS
STUDENT'S MAILING ADDRESS
CITY
STATE
ZIP CODE
STUDENT'S PERSONAL EMAIL (ICLOUD, @GMAIL, ETC.)
STUDENT'S PHONE NUMBER
NAME OF PARENT #1 (USED FOR PRESS RELEASE.)
ADDRESS OF PARENT #1
NAME OF PARENT #2 (USED FOR PRESS RELEASE.)
ADDRESS OF PARENT #2
HAVE YOU INTERNED WITH NEX-GEN BEFORE?
Yes
No
IF YES, WHAT YEAR(S):
Please answer each of the following questions using 150-250 words per question.
QUESTION #1: WHAT ARE YOUR FUTURE CAREER PLANS?
QUESTION #2: WHY ARE YOU EXCITED ABOUT THIS INTERNSHIP, AND HOW DO YOU FEEL IT WILL HELP YOU PREPARE YOU FOR YOUR FUTURE?
QUESTION #3: WHAT DO YOU ENJOY MOST ABOUT LIVING IN NORTHWEST OR NORTH CENTRAL KANSAS?
NEX-GEN APPAREL: INTERNS WILL RECEIVE ONE, NEX-GEN LOGOED T-SHIRT. PLEASE INDICATE YOUR SIZE.
XS
S
M
L
XL
XLT
2X
3X
4X
Acknowledgements
Intern Code of Conduct
Interns, like all employees, represent and are the “face” of the company or organization. If chosen as an intern, you will be expected to maintain professionalism, provide excellent customer service, follow company policies and procedures, and demonstrate a strong work ethic and a willingness to learn and succeed.
Confidentiality Agreement:
You will be expected to uphold confidentiality in respect to your employment at your hiring business and interactions with other businesses, customers, and community members. This includes information pertaining to personnel, patient, customer, and all other company or proprietary information, passwords, and security codes. By submitting this application, you acknowledge, understand, and agree, that, if hired, you will remain confidential and adhere to your hiring company’s and Nex-Generation’s policies regarding confidentiality. Further, you understand that this is a condition of your initial hiring and continued employment. It is further understood that this duty of confidentiality extends beyond your employment with your hiring company, and, if your employment should end at any time, you agree to continue to maintain and hold confidential all information belonging to that company and Nex-Generation from that time forward. Additionally, you understand that should it be necessary to enforce this agreement, your hiring company will be entitled to seek and obtain such injunctive relief as is necessary to preserve its confidential information in court of competent jurisdiction, it being recognized that monetary damages would not provide an adequate remedy to stop the use or disclosure of the company’s trade secrets and confidential information.
Media Consent:
By submitting this application, you acknowledge and give permission to Nex-Generation Round Up for Youth, Inc. to use any still photos, video, or audio transcriptions of yourself that are taken during the Nex-Generation program, for any promotional use by Nex-Generation. Parent must also sign this application if you are under 18.
Dress Code:
Interns are expected to follow the dress code of the hiring business, including the use of personal protective equipment, such as face masks, eye protection, gloves, footwear, etc.
Payroll/General Employment Information/Evaluations:
Interns are hired by the respective business at a part-time, hourly wage. Interns must demonstrate accountability by arriving on time and limit absences to emergencies or scheduled time off for vacation or appointments. Supervisors will evaluate performance and provide feedback, mentoring, and coaching.
Program Attendance Requirements:
Interns are expected to attend programs established by Nex-Generation as part of the internship experience, including one orientation, one leadership day, and one graduation day. (Dates will be provided.) Interns will give a short presentation about their internship experience to a board, staff, or community/civic group, as well as a final “success story” presentation at Intern Graduation Day.
Acknowledgement:
I have read, understand, and acknowledge the contents provided in this internship application. Everything I have presented in this application is true to the best of my knowledge. I give consent to media and agree to uphold confidentiality, if I am hired as an intern in this program.
STUDENT APPLICANT SIGNATURE
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DATE
MM slash DD slash YYYY
PARENT OF LEGAL GUARDIAN (IF APPLICANT IS UNDER 18)
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DATE
MM slash DD slash YYYY
Questions:
Jacque Beckman, Executive Director
Nex-Generation Round Up for Youth, Inc.
877-567-7872, Ext. 5102 (Office)
785-567-3222 (Cell)
NEX-GENERATION WILL FORWARD YOUR APPLICATION TO EACH BUSINESS TO WHICH YOU APPLY.
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