PARKS,RECREATION&CULTURALSERVICES
YOUTHANDADULTSPORTS
InternshipApplication
PERSONALINFORMATION
Name: DateofBirth:
CurrentAddress:
City: StateandZip:
CellPhone:(areacode) EMailAddress:
PermanentAddress:
City: StateandZip:
EmergencyContactName: Phone(areacod e):
RelationshiptoIntern:
Listanymajormedicalconditions&
\
allergies:
SCHOOLINFORMATION
CollegeorUniversity:
CollegeorUniversityAddress:
City: StateandZip:
AdvisorName: AdvisorPhone (areacode):
CollegeMajor: AreaofEmphasis:
Whendoyouexpectto
graduate?
College/University
Advisor’semailaddress:
ORGANIZATIONSANDCERTIFICATIONS
Doyoubelongtoanyprofessionalorganizations? Ifso,list:
Areyoucertifiedin…
FirstAid ExpirationDate:
CPR ExpirationDate:
Other(list) ExpirationDate:
Other(list) ExpirationDate:
INTERNSHIPINFORMATION
RequestedInternshipDates:
Willyouhaveaccesstoavehicleduringyourinternship? Yes No
Listanyspecificcollege/universityrequirementsneededforsuccessfulinternshipcompletion,e.g.,specialproject
completion,classinstruction,journalarticlesubmission,….(Ifnecessary,attachadditionalpages.)
Arethereanypersonalconsiderationsthatmayaffectyourinternshipplacement?
SPECIALNOTES:
TheCityofColoradoSpringsTherapeuticRecreationinternshipprogramdoesnotguaranteeinternhousing.NOTE:Insomecases,
accommodationsmaybeavailablethroughtheParks,RecreationandCulturalServicesDepartment.
TheCityofColoradoSpringsTherapeuticRecreationProgramdoesnotprovideapaidinternshipprogram.Workopportunitieswithin
theParks,Recreation&CulturalServicesDepartmentmaybeavailableoutsideofinternshiphours.
Aninpersonorphoneinterviewwillbeconductedwithallapplicantspriortoplacement.
PERSONALGROWTH(Attachresponsestoapplication.)
1. Listyourshorttermgoals.
2. Listyourlongtermgoals.
3. WhatcanyouoffertheCityofColoradoSpringsYouthandAdultSportsprogramasanintern?
4. Describeyourspecialabilitiesintheareasofrecreationandleisure?
5. Regardingyourinternship,whattypeofexperienceareyouseekingineachofthefollowingareas?Pleaseexplain.
Areaoffocus
(population,age,…)
Typeofspecial/finalprojects
Administrativeexperience
Interpersonalskillbuilding
Leadingandimplementingprograms/activities
Supervisoryexperience
Otherknowledgeyoumayneedorwouldliketohave
6. Pleasewriteabriefparagraphexplainingyourbackground,experienceandmotivationforchoosingRecreationasyour
fieldof
study.AlsoincludewhyyouchoseColoradoSpringsasapossiblesite.
REFERENCES
Pleaselistthenames,titles,addressesandphonenumbersofthreereferencesforwhomyouhaveworkedinarecreation
setting(includingvolunteerwork):
Name: Title:
Address: StateandZip:
Phone:(areacode) EMailAddress:
Name: Title:
Address: StateandZip:
Phone:(areacode) EMailAddress:
Name: Title:
Address: StateandZip:
Phone:(areacode) EMailAddress:
PLEASEATTACHYOURRESUMETOTHISAPPLICATION