INTERNSHIP APPLICATION

Please submit this application along with your resume and cover letter. OMSI will not consider incomplete applications.

Please note that OMSI internships are unpaid, volunteer opportunities.

Internship Position(s) You are Seeking
/
Date of Application

How did you learn about this position?

Advertisement (specify) ______FriendOMSI Employee

Visiting OMSI Website (specify) ______College (Specify) ______

Personal Information
First Name
/
Last Name
Address
City
/
State
/
Zip
/
Email
Home Phone #  Preferred Number?
/
Cell Phone #  Preferred Number?
Permanent Address (if different than above)
City
/
State
/
Zip Code

Permanent Phone #

Emergency Contact Name / Relationship / Phone #
Have you ever been employed or volunteered with OMSI before?Yes No
If yes, give date and position:
To the extent permitted by applicable law, have you ever been convicted of a crime? (Note: the existence of a conviction record is not necessarily a bar to serving as an intern.) Yes No
If yes, please give details and dates: ______
Can you provide volunteer service with reasonable or no accommodation? Yes N

Availability and Interests

Date available to begin: ______I can commit to up to ______hours per week.
I will commit to at least (circle: 3 6 9 12 ) months as an OMSI intern.
Please circle when you are available: M T W Th F Sat Sun Mornings Afternoons Evenings
If you are applying for an internship in Science Education, please rank the top five (5) OMSI Science Education areas that interest you, where 1 is your area of highest preference for placement, and 5 is your area of lowest preference for placement (but is still an area in which you’d be interested):
___ Chemistry Lab___ Food Science ___ Teen Science Alliance
___ Physics Lab___ Featured Exhibits Hall
___ Design Lab___ Earth Science Hall (Paleo and Earth Science Labs)
___ Life Science Lab ___ Early Childhood Education (Science Playground)

Education and Training

Name of School / Course of Study (include focus, if applicable) / # Yrs / Degree
Undergraduate School / Yes
No
Graduate School / Yes
No

Please list any applicable coursework/training(include software)______

______

Work Experience

Are You Currently Employed? Yes No

If yes, please list your current place of employment: ______

Job title: ______

Professional/Personal References

Name / Email Address and Phone Number / Title
1.
2.

Applicant’s Certification – please read carefully before signing this application

OMSI is an equal opportunity employer and is dedicated to similarly extending that same commitment to its volunteer positions; therefore we will consider applicants for all volunteer internship positions without regard to race, color, sex, religion, creed, age, national origin, sexual orientation, gender identity, citizenship status, physical or mental disability, veteran's status, or any other status protected under applicable local, state, or federal law.

The skill-sets of intern applicants are generally compared to those skill-sets needed to fulfill current internship positions. Placement is typically made based on the recommendation of the volunteer staff and the applicant's prospective volunteer supervisor, and the willingness and ability of the applicant to perform the required volunteer duties at the times needed by the museum. Interns must be able to perform activities of daily living without assistance from OMSI staff while volunteering.

  • I certify that I have answered truthfully and have not knowingly withheld any information relative to my application. I understand that any misrepresentation or material omission of the application will result in my being eliminated from further consideration. I further understand that, if accepted, any misrepresentation on written applications or in interviews that becomes known to OMSI may result in immediate dismissal.
  • I authorize all previous employers, supervisors, and others with information, including all persons with and for whom I have worked or volunteered, to give OMSI’s representative any relevant information regarding my previous employment or volunteerism, and job or volunteer performance. I release OMSI and all previous employers, supervisors, or others with information from liability for any damages that may result from furnishing information to OMSI.
  • I acknowledge and agree that I offer my services as a volunteer intern at my own initiative and for humanitarian purposes, without promise, expectation or receipt of pay or future employment.
  • I understand that I will be required to attend an orientation and department specific training.
  • I agree to abide by existing and future instruction, rules and policies of OMSI. I understand that my volunteer position may be terminated at any time, at the option of either OMSI or myself.

I have read, understand and agree to the above certification statements and other information on the application.

Applicant’s Signature Date

Typed name accepted as signature