Summer Intern Program Application
Interns will work together to create a presence for PREP at area festivals and special events throughout the valley in conjunction with creating a positive social media campaign in support of their community involvement. Teen interns will work 2-5 hours a week throughout the summer. Most meetings will take place in Glenwood Springs. Bus passes or mileage will be paid by PREP for all meetings.
Name:______
Address:______City/State/Zip:______
School:______
Current Year In School: Freshman Sophomore Junior Senior Other: ______
Home Phone:______Cell Phone: ______
Email Address:______
Emergency Contact Name: ______
Emergency Contact Phone Number: ______
The following question are optional:
Age: ______Date of Birth:______
Gender: Male Female
Race/Ethnicity:______
Parent Information:
Parent/Guardian Name:______
Parent/Guardian Phone Number:______
Parent/Guardian Signature: ______
(By signing you understand your youth will be participating in an internship which promotes comprehensive sexual education in our local communities)
Personal Reference (over 18 and not a family member):
Name:______
Phone Number:______
Meeting Attendance
Attending meetings is mandatory. Will you be able to attend and participate in meetings once a week for two hours?
(Please Circle): Yes No
Do you know of any planned vacations or times where you will not be available? If so, please list below: ______
Your Transportation Plan How are you going to get to meetings if they are in Glenwood Springs? (Please let us know if you need help developing one.)
Will you need a bus pass?(circle one)YESNO
Youth: My signature affirms that if my application is selected, I will make a commitment to Garfield County PREP by attending meetings and participate in the planning and implementation of community awareness project for comprehensive sexual health education. I will represent the Garfield County PREP program in a positive and exemplary manner.
Youth SignatureDate
Permission to use photograph
Subject: Promoting comprehensive sexual health education for all youth in Garfield County
Purpose: video, print or web photographs for the Garfield County PREP program only.
I grant to Garfield County PREP, its representatives and employees the right to take photographs of me or my child in connection with the above-identified subject.
I authorize Garfield County PREP its assigns and transferees to copyright, use and publish the same in print and/or electronically.
I agree that Garfield County PREPmay use such photographs of me or my child with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.
I have read and understand the above:
Signature ______Date: ______
Printed name ______
Signature, parent or guardian(if under age 18)______