_______________________________________ ________________________________ ____________
____________________________ _______________________ ____________________
State of Florida
Department of Environmental Protection
INTERNSHIP APPLICATION
Todays Date: _________________________
All prospective Interns mu
st be 18 years of age or older to be
considered. Please email this completed application and required
d
ocumentation to DEP_Internships@dep.state.fl.us or by mail to
the Department of Environmental Protection, Bureau of Human
Resource Management, MS#70, ATTN: Employee Relatio
ns-
Internships. Please call 850.245.2524 if you have questions.
NOTE: Typically, in
terns do not receive any form of financial
compensation from the Department. The internship is completed
by the student for the purpose of earning hands-on experience
and/or academic credit.
Last Name First Name Middle Initial
________________________________________ __________________________ ______ _________
Current Address: City: State: Zip:
If different, Permanent Address:
________________________________________ __________________________ ______ _________
Current Address: City: State: Zip:
Home Phone Work Phone Cell Phone
____________________________ Are you looking for a Internship?
Email Address:
Are you currently enrolled in a College or University? Yes No
If Yes, what is the name of the College or University: _________________________________________
Education Level: Major: __________________________________________
Minor: __________________________________________
Current GPA: ____________ Expected Date of Graduation: _____________________
How did you hear about our internship opportunities?
DEP Internship Application (05-15-2015)
Select One
Select One
Why would you like to intern at the Department of Environmental Protection?
If you check Yes to any of the following questions, please provide relevant information.
Are you fulfilling a school requirement? (If yes, explain) Yes No
Are you fluent in any foreign languages? (please list) Yes No
Are you a member of any environmental organizations? (please list) Yes No
In addition to our Tallahassee offices, the Department of Environmental Protection has six regulatory districts.
Please check which location(s) you would prefer to intern at:
Headquarters (Tallahassee)
Southeast District (West Palm Beach)
Northwest District (Pensacola)
South District (Ft. Myers)
Northeast District (Jacksonville)
Central District (Orlando)
Southwest District (Tampa)
I am interested in Interning with (check one):
Legislative Affairs Technical Services
/Community Relations
Environmental Resources
Legal
Finance & Accounting
Recreation and Parks
Human Resource Management
DEP Internship Application (05-15-2015)
List any prior internships or volunteer experience(s) and include the organization(s) name, position(s) held, and
dates:
Organization Name:
Position Held:
Begin Date: ___________________ End Date: ______________________
Organization Name:
Position Held:
Begin Date: ___________________ End Date: ______________________
I’m available for approximately ___________ hours/week.
In the box below please list the number of hours from Monday through Friday that you are able to work.
_________ Monday _________ Friday
_________ Tuesday _________ Saturday
_________ Wednesday _________ Sunday
_________ Thursday _________ Total Hours per Week
Are you a U.S. citizen, or legally authorized to work in the U.S? Yes No
If you answered “Noplease provide the appropriate documentation needed to work in the U.S.
IF YOU ANSWERED “YES” TO ANY OF THE FOLLOWING QUESTIONS, PLEASE PROVIDE AN
EXPLANATION TO INCLUDE DATE(S) AND LOCATION(S) OF CONVICTION(S) AND THE
DISPOSITION(S).
Have you ever been convicted of a 1
st
degree misdemeanor or felony? Yes No
(If yes, provide the charge(s), where convicted and the dates of conviction)
Charges:
Where:
Dates: ___________________________________
DEP Internship Application (05-15-2015)
__________________________________________ _______________________
Have you ever pled nolo contendere or pled guilty to a crime which is a first degree misdemeanor or felony?
(If yes, provide the charge(s), where and the dates) Yes No
Charges:
Where:
Dates: ___________________________________
Have you ever had the adjudication of guilt withheld for a crime which is a first degree misdemeanor or felony?
(If yes, provide the charge(s), where and the dates) Yes No
Charges:
Where:
Dates: ___________________________________
Notification and Agreement
(Please read before signing)
I certify that all answers given by me are true, accurate, and complete. I understand that the falsification,
misrepresentation or omission of facts on this application (or any other required documents) will be cause for denial,
regarding of when or how discovered. I consent to the release of information about my ability, employment history,
and fitness for employment by employers, schools, law enforcement agencies, and other individuals and
organizations to investigators, personnel staff, and other authorized employees of Florida state government for
employment purposes. This consent shall continue to be effective during my internship.
Signature of Intern Date
Required documentation:
Application
Cover letter
Resume
Official Transcript
Letter(s) of Recommendation (At least one letter from Academic Advisor or Professor in the area of study.)
Plea
se email this form and required documents to: DEP_Internships@dep.state.fl.us
You may also print a copy and mail to:
Department of Environmental Protection, Bureau of Human Resource Management ATTN: Terry
Shine, Employee Relations
3900 Commonwealth Blvd., MS# 70, Tallahassee, Fl. 32399
Or send via fax at 850-412-0704 - ATTN: Employee Relations - Internships
DEP Internship Application (05-15-2015)
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