Rooftops Canada

Young Professional Intern Program

2013 APPLICATION FORM

Please type your responses and complete the entire form in English.

Use as much space as needed to answer each question. Your responses

will remain confidential.

GENERAL INFORMATION
Last Name: / First Name: / Middle Name(s):
E-mail: / Date of Birth: / Age: / Social Insurance Number:
Current Address: / Home Telephone: / Work telephone:
Permanent Address (if different): / Home Telephone: / Work telephone:
Do you have any health requirements (allergies, diet, etc) or conditions that might affect a six-month overseas placement? If yes, please describe.
How did you learn about Rooftops Canada’s Intern Program?
Would you like to be added to Rooftops Canada’s E-bulletin distribution list to receive regular updates about our partners and programs?
ELIGIBILITY Y N
Are you between the ages of 19 and 30?
Are you a Canadian citizen or Permanent Resident?
Will you be a graduate of a university or college degree program by April 2013?
Have you previously worked in Africa, Asia, Latin America, or Central/Eastern Europe in a paid career-related position?
Have you previously participated in one of the following Internship Programs funded by the Federal Government's Career Focus Program of the Youth Employment Strategy (YES)?
  • Agriculture and Agri-Foods Canada – Youth Employment;
  • Canadian Food Inspection Agency – Youth Employment;
  • Canadian Heritage – Young Canada Works at Building Careers in Heritage / Young Canada Works at Building Careers in English and French;
  • Canadian International Development Agency - International Youth Internships;
  • Environment Canada - Environmental Youth Corps;
  • Fisheries and Oceans - Youth Work Experience;
  • Foreign Affairs and International Trade – Young Professionals International;
  • Human Resources Development Canada – Career Focus / International Academic / Mobility;
  • Industry Canada - School/Net Youth Initiative / NetCorps Canada International / Community Access Program Youth Initiative / Student Connections / Computers for Schools;
  • National Research Council Canada – Internship Program with Small and Medium-sized Enterprises (SMEs) / Collaborative Research Internships;
  • Natural Resources Canada - Science and Technology Internship Program

Are you unemployed or underemployed (working in a job that is not directly linked to your academic training)?
QUALIFICATIONS AND SKILLS
Post-secondary degrees/diplomas / Specialization / Institution / Month/Year of Completion
Have you ever participated in any overseas study, work, or volunteer programs? If yes, please describe.
Languages in order of strength / Speaking (1=basic; 5=fluent) / Reading (1=basic; 5=fluent) / Writing (1=basic; 5=fluent)
Please list all computer software with which you are proficient.
Describe your personal interests (e.g. community involvement, volunteer activities, clubs, hobbies, etc.).
Describe other special skills, background or experiences that qualify you for an internship with Rooftops Canada.
EMPLOYMENT HISTORY(Please indicate any employers we CANNOT contact for references.)
CURRENT/LATEST EMPLOYER
Name of Employer / Address, Telephone Number / Dates of Employment
Job Title / Name and Title of Supervisor / Monthly Salary
Description of Duties / Reason for Leaving
PREVIOUS EMPLOYER (1)
Name of Employer / Address, Telephone Number / Dates of Employment
Job Title / Name and Title of Supervisor / Monthly Salary
Description of Duties / Reason for Leaving
PREVIOUS EMPLOYER (2)
Name of Employer / Address, Telephone Number / Dates of Employment
Job Title / Name and Title of Supervisor / Monthly Salary
Description of Duties / Reason for Leaving
SUITABILITY FOR OVERSEAS PLACEMENT
Why are you interested in an internship with Rooftops Canada?
How would an internship with Rooftops Canada relate to your professional and personal goals?
Describe your ideal overseas work placement. Include what type(s) of work you would most like to do and why.
Rooftops Canada’s interns will be required to adapt to new living conditions, work with people from different cultural and socio-economic backgrounds, and demonstrate flexibility when schedules and plans change beyond their control. Describe your ability to adapt to new and changing situations, providing an example where possible.
AVAILABILITY
Are you presently registered in an academic program? (If yes, when will classes end and what is your anticipated date of graduation? Include details of thesis work to be completed.)
Are you presently employed? (If yes, indicate how soon you could leave your current job for an internship.)
Our program is scheduled to run from May/June 2013 toNovember/December 2013. (with a five day mandatory orientation session late April or early May) and a debriefing session at the end of the internship)Please provide details on future plans, both personal and professional, which may affect your participation (i.e., MA or Ph.D. candidate, bar exams to complete, wedding to attend, etc).
How did you hear about the internship? CCA Website: Rooftops Canada Website: Universities: Associations:
Other (explain):
REFERENCES
Please provide the names and contact information for two references. These may include an employer, supervisor, teacher, or a person with whom you have done community or volunteer work.
Name:
Location:
Telephone:
E-mail:
Relationship: / Name:
Location:
Telephone:
E-mail:
Relationship:

In submitting this application, I hereby certify that the information given is true and can be verified, and I consent to the use of this information only for the purposes of recruitment and placement by Rooftops Canada of its 2013 interns.

Name of Applicant:
Date:

Application deadline: Monday April 15, 2013. EST. To apply, please complete this form and send it together with your CV (résumé) and cover letter by e-mail to

ONLY short-listed candidates will be contacted.No phone calls please.

Rooftops Canada will only use the information collected on this form for the purposes of recruitment and placements of its 2013interns. Applicants will only receive our e-Bulletin if they specifically request to be added to the distribution list.

Rooftops Canada – Internship Program 2013 Application Form 1