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Fields in bold are required.
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I. PERSONAL INFORMATION
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First Name:
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Middle Name:
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Last Name:
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Current Address:
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Address 2:
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City:
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State:
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Zip Code:
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Current Phone:
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Permanent Address:
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Address 2:
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City:
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State:
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Zip Code:
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Permanent Phone:
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E-mail:
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What is your gender?
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What is your ethnicity?
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Are you a military dependent?
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Have you served in the United States Military Service?
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Are you currently on Active Duty Reserves or National Guard?
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Do you have a valid driver's license?
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License#:
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In which state is your license issued:
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Will you have the means to get to work if public transportation is not available?
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Parent, legal guardian, spouse or other person to be notified in case of emergency:
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First Name:
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Last Name:
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Relationship:
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Address:
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Address 2:
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City
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State:
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Zip Code:
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Home Phone:
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Work/Cell Phone:
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II. SCHOOL INFORMATION |
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What university do you attend?
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Are you currently enrolled in a 2 or 4 year accredited university located in the USA?
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If no, explain:
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Are you enrolled in an undergraduate program?
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Are you enrolled in a graduate program?
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Are you a full time or part time student?
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What is your major?
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What is your GPA?
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Is your school classified as a Historically Black College or University?
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Is your school classified as a Hispanic College or University?
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Is your school classified as a Trial College or University?
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III. REQUIRED DOCUMENTATION
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Please upload your resume and include honors, scholarships, achievements, awards,
extra curricular activities (college and professional), community activities, and
list all employment, including volunteer work.
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Please upload a copy of your unofficial transcript. (If you are selected for the program,
an official transcript is required to complete your application.)
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Please upload a brief essay (100-150 words) indicating why you would like to participate
in the internship program.
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IV. LANGUAGE PROFICIENCY
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Do you know sign language?
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Do you speak, write and read English fluently?
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If no, explain:
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Do you speak, write or read any other language(s)
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If yes, indicate language(s):
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V. AVAILABILITY FOR ASSIGNMENT
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VI. DISCLOSURES
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Failure to answer each question truthfully may delay processing your application
and may be grounds for not hiring you. A background investigation will be conducted
on applicants upon selection.
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Have you been dismissed from any job for unethical behavior?
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If yes, explain:
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Are you under charges or investigation for any violation of law committed as an adult?
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If yes, explain:
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VII. ACCOMMODATIONS
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Will you need assistance in locating housing in the Washington, D.C. area?
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Do you require auxiliary aids
or services as specified under the American with Disabilities Act?
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If yes, explain:
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VIII. SIGNATURE
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I certify that the information submitted above is accurate to the best of my knowledge
and I may be disqualified and/or dismissed if false information is presented. If
for some reason it becomes necessary for me to withdraw my application, I agree
to notify Brooks & Associates, LLC, immediately so that I will not deprive someone
else of the chance to participate. I give permission to Brooks & Associates,
LLC. to share this information for the purpose of recruitment and placement. In
consideration of submitting this application, I recognize that by applying to the
program I grant Brooks & Associates, LLC. freedom to use my name, likeness and/or
words in the production of publicity, educational and promotional materials.
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Equifax Secure Global eBusiness CA-1
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Applicant:
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Date:
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