Personal Information
AMP UP! Internship Program Application
Please fill out the application form carefully
Full Name
First Name
Last Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Emergency Contact Full Name
First Name
Last Name
Emergency Contact Phone number
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Questions
What year are you currently completing at Cal State Eastbay?
What is your expected graduation date?
Tell us about yourself
What are your educational aspirations?
What's your dream profession?
Have you ever done community activism or social justice work?
What do you think are the biggest challenges facing the Black community?
What do you hope to get out of the internship?
Do you have time constraints? Can you commit to 8-10 hours a week? This can include weekends and evenings. Please explain:
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