Internship Application - Orange County
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about Olive Crest?
Current Employer
Availability (select all that apply)
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Mornings
Afternoons
Evenings
Weekends
Open availability
What type of internship are you interested in? (Please select no more than 3)
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Fostering & Adoption
Kinship & Visitation
Wrap Around Program
Mental Health
Community Involvement & Events
Safe Families for Children (faith based)
Group Home or Transitional Youth Program
Funding Development, Marketing or Business Administration
Olive Crest Academy
Human Resources
Other
Is this a course required internship?
Yes
No
Education
Are you currently enrolled in a graduate or undergraduate program?
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Yes
No
If you answered 'Yes' to the above question, please give an estimated completion date:
Name of current University, College, or Business School
Major/Subject
Degree Pursuing
Degree/Certificate date completed
Honors Received
Special skills, talents, and training
Other educational, employment, and life experiences that contribute to your work as a volunteer
What languages do you speak, read, or write fluently?
State any additional information you feel may be helpful to us in considering your application
Volunteer Experience
Organization/Program 1
Date
Volunteer Activities and Participation
Organization/Program 2
Date
Volunteer Activities and Participation
Organization/Program 3
Date
Volunteer Activities and Participation
Please list any additional volunteer activities relevant to becoming an intern with Olive Crest
DMV Information
Do you currently have a valid CA drivers license?
Yes
No
Do you have any driving violations in the last 3 years on your DMV driving record?
Yes
No
If 'Yes', please explain
Misc. Background Information
Have you ever been convicted of an offense other than the following?
Yes
No
1. Minor traffic violations for which the fine was $50 or less before April 5, 1984 or $100 or less on or after April 4, 1985 2. Any offense which was finally settled in a juvenile court or under a welfare youth offender law (Offenses which fall under numbers 1 and 2 above need not be reported)
If 'Yes', please explain
Are there any accommodations you would require or any health limitations that may affect your ability to intern with Olive Crest?
Yes
No
If 'Yes', please explain
References
Professional Reference 1 (not related to you)
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Professional Reference 2 (not related to you)
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Short Essay: Please tell us why you are interested in pursuing an internship with Olive Crest. If you are applying for a specific program or department please include specific information pertinent to that position.
Policy and Confidentiality Statements
Information about past or present Olive Crest clients, constituents or Olive Crest’s business activities is not to be disclosed to anyone outside of Olive Crest. Olive Crest clients’ names and cases are to remain confidential and are not to be disclosed to anyone outside of Olive Crest employees (including other clients) or to be discussed at locations other than Olive Crest facilities. Information about Olive Crest clients, constituents or business activities is not to be discussed with or released to the press or any other news media unless authorized by Olive Crest’s chief executive officer. Photographs of clients are not to be displayed or made public. -Addresses and telephone numbers of group homes and foster homes are not to be disclosed to anyone outside of Olive Crest unless authorized by Olive Crest’s chief executive officer. In addition, visitors (including friends and relatives of Olive Crest employees) are not to be allowed in Olive Crest facilities or with Olive Crest clients unless prior approval has been obtained from the supervisor. -Olive Crest requires any volunteer, who has knowledge of or observes a child in his or her volunteer position whom he or she knows or reasonably suspects has been the victim of child abuse, to report the known or suspected instance of child abuse to a child protective agency immediately or as soon as practically possible by telephone and to prepare and send a written report there of with in 36 hours of receiving the information concerning the incident. -I understand that Olive Crest accepts no responsibility for any personal items brought by me to any Olive Crest site. I assume full responsibility for any personal items I bring to an Olive Crest site. -I understand Olive Crest requirements regarding confidentiality and my responsibility to maintain confidentiality in my role as a volunteer. By virtue of my association with Olive Crest, I am mandated to comply with the child abuse reporting requirements as stated above. I hereby acknowledge that I will comply with Olive Crest policies during and after my volunteerism with Olive Crest.
Signature
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Date
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Month
-
Day
Year
Date
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