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Intern Background Survey
This survey has 4 sections and should take no more than 10 minutes to complete. Your responses will help us gain a better understanding of what you need and which student interns would best fit in your classroom next school year.
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1
1. First Name
*
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2. Last Name
*
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Nice to meet you {1First}!
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3
3. Email
*
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{1First}, where can we reach you?
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4
4. College
*
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5
5. Year in College
*
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Freshman (1st Year)
Sophomore (2nd Year)
Junior (3rd Year)
Senior (4th Year)
Masters
Doctorate
Graduated
None
Freshman (1st Year)
Sophomore (2nd Year)
Junior (3rd Year)
Senior (4th Year)
Masters
Doctorate
Graduated
None
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6
6. City you Live In
*
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7. Tell us more about your location and means of transportation
*
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What are your nearest cross streets?
Osborn
Alhambra
Union District
Osborn
Alhambra
Union District
Which of these districts is your desired placement?
What is your current means of transportation?
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8
8. What is your current motivation to connect with MDTP?
*
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School
Class
Other
School
Class
Other
Motivation
Please provide details for School, Scholarship, or Other
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9
9. Do You Have a Finger Print Clearance Card?
*
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Yes
No (but I would be able to get one)
No (I will not be able to get one)
No (I'm not sure if I can get one)
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10
Review Position Descriptions & Responsibilities
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11
1. What Position are You Interested In?
*
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Classroom Support Team
Executive Assistant
Marketing
Special Events Management
Teacher Recognition
Teacher Support
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2. Main Reason for Applying for this Internship
*
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3. # of Hours You Plan on Committing to Intern Each Week
*
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0 Hrs
2 Hrs
4 Hrs
6 Hrs
8 Hrs
8+ Hrs
Work On Campus
Work Off Campus
Work On Campus
Work Off Campus
0 Hrs
2 Hrs
4 Hrs
6 Hrs
8 Hrs
8+ Hrs
0 Hrs
2 Hrs
4 Hrs
6 Hrs
8 Hrs
8+ Hrs
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4. Major Setback if You Do Not Pass the Internship
*
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Fail Class
Lose Scholarship
No Setback
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5. Do you have experience in the position in which you are applying for?
*
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No
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1. Functions (hidden, not shown)
We would like to identify the functions as an intern which you would feel comfortable doing / learning how to do. Please check all that apply:
Yes
No
I Don't Know
Data Input/Upload [Documents, Pictures, Grades]
Data Analysis
Grading Student Work
Taking Pictures of Students During School/Classroom Activities
Notifying Parents Regarding Reminders and Classroom/School Activities
Meeting with Parents in Person to Discuss Child
Lesson Preparation
Teaching
Leading Small Student Groups
Tutoring
Taking Notes on Each Student [Behavior, Academics, Needs, Etc.]
Data Input/Upload [Documents, Pictures, Grades]
Data Analysis
Grading Student Work
Taking Pictures of Students During School/Classroom Activities
Notifying Parents Regarding Reminders and Classroom/School Activities
Meeting with Parents in Person to Discuss Child
Lesson Preparation
Teaching
Leading Small Student Groups
Tutoring
Taking Notes on Each Student [Behavior, Academics, Needs, Etc.]
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
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17
1. Please provide examples of past work and life experiences that relate to any of the functions of the position.
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2. We would like to know of the types of relevant software you already know how to use. Please check all that apply:
Yes
No
I Don't Know
Microsoft Office: Word, Excel, PPT
Class Dojo
Site Word Packet
Mobymax Site
Microsoft Office: Word, Excel, PPT
Class Dojo
Site Word Packet
Mobymax Site
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
Yes
No
I Don't Know
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19
1. Please Rank the Following Profiles from 1-4 (1 Most Like You and 4 Is Least Like You).
Each Profile Should Only Have 1 Box Checked That is Not Duplicated By Another.
1
2
3
4
Analytical [Clear thinker, Logical Problem Solver, Data Driven, Rational, Learns by Mental Analysis]
Structural [Practical Thinker, Likes Guidelines, Cautious of New Ideas, Predictable, Learns by Doing]
Conceptual [Imaginative, Intuitive About Ideas, Visionary, Enjoys the Unusual, Learns by Experimenting]
Social [Relational, Intuitive About People, Socially Aware, Empathetic, Learns from Others]
Analytical [Clear thinker, Logical Problem Solver, Data Driven, Rational, Learns by Mental Analysis]
Structural [Practical Thinker, Likes Guidelines, Cautious of New Ideas, Predictable, Learns by Doing]
Conceptual [Imaginative, Intuitive About Ideas, Visionary, Enjoys the Unusual, Learns by Experimenting]
Social [Relational, Intuitive About People, Socially Aware, Empathetic, Learns from Others]
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
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2. Check the Box of one Characteristic that Best Describes You
Quiet
Introspective
Reserved
Talkative
Gregarious
Expressiveness
Expressiveness
Quiet
Introspective
Reserved
Talkative
Gregarious
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21
3. Check the Box of one Characteristic that Best Describes You
Peacekeeping
Easygoing
Competitive
Forceful
Driving
Assertiveness
Assertiveness
Peacekeeping
Easygoing
Competitive
Forceful
Driving
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22
4. Check the Box of one Characteristic that Best Describes You
Focused
Firm
Adaptable
Accommodating
Welcomes Change
Flexibility
Flexibility
Focused
Firm
Adaptable
Accommodating
Welcomes Change
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5. What Other Skills Do You Possess That You Feel Will Make You A Good Candidate For A Position?
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