INTERNSHIP APPLICATION

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Position

Name*

First Last

Gender

Ethnicity

Email*

Date of Birth*

MM slash DD slash YYYY

Address

Street Address Address Line 2 City State ZIP Code

Phone

LinkedIn Address (if available)

Emergency Contact (Name, Relationship, & Phone Number)*

Are you authorized to work in the US*

Yes

No

If so, select appropriate option

U.S. Citizen

LPR/ Green Card

EAD/ Work Permit

OPT

Other

When can you start?*

MM slash DD slash YYYY

Do you have a car that can be used for work if necessary for the position? (Some positions may require travel to different locations)*

Yes

No

How did you hear about ATASK?*

What attracted you to this work?*

Do you speak any other languages other than English?*

Yes

No

If so, what languages and what fluency (basic/intermediate/advanced/native speaker)?

Please share your education, work, volunteer, or life experiences related to domestic violence, other forms of violence and oppression, or the Asian community*

What experiences are you hoping to gain from interning at ATASK?*

How have you navigated working or interacting with individuals from diverse cultures, races, ethnicities, or sexual orientations? Please share an experience that reflects your approach.*

Please provide two professional references (Name, Phone Number, Email, Relationship to you)*

Upload your resume and cover letter*

Drop files here or

Accepted file types: pdf, Max. file size: 20 MB.

Agreement

I certify that all information on this application and any other material provided by me is true and complete.

Name*

Date*

MM slash DD slash YYYY