Arlington Teens
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 Web Site Internship Application 

Send completed application form and work samples to: Sally LaBonte 2100 Washington Blvd., Suite 300, Arlington, VA 22204, email to: slabonte@arlingtonva.us or fax to: 703-228-1122. Applications will be reviewed on a rolling basis for as long as positions remain open.
Applicant Information
Full Name: Date:
Last First M.I.
Address:
Street Address Apartment/Unit #
City State ZIP Code
Phone: (         ) E-mail Address:
Date Available: Social Security No.: Grade:
School:
Are you available to work on weekends? YES
0
NO
0
Are you able to work evenings? YES
0
NO
0
 
Specialties:
Options: Writing, Web Development/Design, Graphic Design, Marketing, YouTube Video-Making, Podcasting, Photography, Comic, Facebook, Wordpress 
Training
Class: Institution:
From: To: Skills Learned:
Class: Institution:
From: To: Skills Learned:
Class: Institution:
From: To: Skills Learned:
 
References
Please list three professional references (One must be a teacher).
Full Name: Relationship:
Company: Phone: (         )
Address:
Full Name: Relationship:
Company: Phone: (         )
Address:
Full Name: Relationship:
Company: Phone: (         )
Address:
Previous Employment/Internships
Company: Phone: (         )
Address: Supervisor:
Job Title: Starting Salary: $ Ending Salary: $
Responsibilities:
From: To: Reason for Leaving:
May we contact your previous supervisor for a reference? YES
0
NO
0
 
Company: Phone: (         )
Address: Supervisor:
Job Title: Starting Salary: $ Ending Salary: $
Responsibilities:
From: To: Reason for Leaving:
May we contact your previous supervisor for a reference? YES
0
NO
0
 
Company: Phone: (         )
Address: Supervisor:
Job Title: Starting Salary: $ Ending Salary: $
Responsibilities:
From: To: Reason for Leaving:
May we contact your previous supervisor for a reference? YES
0
NO
0
 
 
Work Samples
If possible, please include two to three samples of your work with this application. Examples of work samples may include a school assignment, article written for a yearbook or student newspaper or blog entry written for a website. You also may provide links to YouTube videos, websites or Podcasts you have created. This work will NOT be returned to you. 
Disclaimer and Signature
 
I certify that my answers are true and complete to the best of my knowledge. 
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature: Date: