Application for 10-week Volunteer Internship: Spring/Summer 2017 First Name: (*) Invalid Input Last Name:(*) Invalid Input Address: (*) Invalid Input City: (*) Invalid Input State:(*) Invalid Input Zip: (*) Invalid Input Email:(*) Invalid Input Home Phone:(*) Invalid Input Cell Phone:(*) Invalid Input Work Phone: Invalid Input Occupation: Invalid Input Birth Date:(*) Month010203040506070809101112 / Day01020304050607080910111213141516171819202122232425262728293031 / Year194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020Invalid Input Have you had a tetanus shot within the past ten years?(*) YesNoInvalid Input Are you covered under a personal or family medical plan?(*) YesNoInvalid Input Relevant courses/experience: Invalid Input Career Goal: Invalid Input Why are you interested in interning at the MMCC? (*) Invalid Input How did you hear about this internship? (*) MMCC WebsiteOther WebsiteSocial MediaWord of MouthCollege/University listingOtherInvalid Input Please list two references: Name: (*) Invalid Input Phone: (*) Invalid Input Email: (*) Invalid Input Address: Invalid Input Name: (*) Invalid Input Phone: (*) Invalid Input Email:(*) Invalid Input Address: Invalid Input Have you previously applied or volunteered for our organization? (*) YesNoInvalid Input Dates you are available for your rotation: Earliest start date: (*) Invalid Input Latest end date: Invalid Input We currently offer spring rotations (starting in January-February) and summer rotations (starting in April-August). Interns are expected to commit 30 hours/week for a period of 10 weeks. Weekly scheduling is arranged at the start of the internship. Emergency contacts: Name: Invalid Input Phone: Invalid Input Physician: Invalid Input Phone: Invalid Input Interns are responsible for their own transportation, housing, and medical insurance. Additionally, foreign students are responsible for arranging all necessary visas and permits. Interns are not covered by workman's compensation. You are required to sign a General Release form which waives any liability of the Marine Mammal Care Center at Fort MacArthur should you be injured while performing your duties. Applicants will be expected to successfully complete a criminal background check prior to beginning the internship. By submitting this form, you may receive monthly updates about MMCC and its patients. To unsubscribe at any time, click "SafeUnsubscribe" on the bottom of any emails you receive.