Fillable VOLUNTARY INTERNSHIP APPLICATION Montgomery County Circuit Court 50 (Montgomery County Maryland)

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VOLUNTARY INTERNSHIP APPLICATION Montgomery County Circuit Court 50 (Montgomery County Maryland)

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VOLUNTARY INTERNSHIP APPLICATION
Montgomery County Circuit Court
50 Maryland Avenue, North Tower, Room 3121
Rockville, MD 20850
240-777-9100
The Montgomery County Circuit Court would like to thank you for applying for a voluntary
internship. In order to be considered for an unpaid internship with the Circuit Court, please provide
us with the information below. Interested candidates should be aware that there are a limited
number of internships available; receipt of your application does not guarantee your selection
for a position. Internships are considered for the school year as well as the summer months.
Download this application and save it to your personal computer or laptop before
emailing it to QCInternship@mcccourt.com.
SECTION 1 – INTERN POSITION INFORMATION
Time period for which you are applying: School Year Summer
Date available to begin the Internship:
Ten
tative Schedule:
Sum
mer: (A minimum of 12 hours per week, four hours/day minimum)
Please list the hours you are available between the hours of 8:30 am and 4:30 pm.
Monday Tuesday Wednesday Thursday Friday
School
Year: (A minimum of nine hours per week, three hours/day minimum)
Please list the hours you are available between the hours of 8:30 am and 4:30 pm.
Monday Tuesday Wednesday Thursday Friday
2
SECTION 2 – PERSONAL DATA
Name:
Middle Name or Initial
Cell:
Last First
Address: (include city, state, zip):
Email Address:
Telephone numbers: Home:
Emergency Contact Name and Telephone Number:
Have y
ou ever interned for the Circuit Court before? Yes No
If so
, when and in what department(s)?
Pleas
e indicate the source(s) from which you learned of our internship program
(check all that apply):
Ref
erral from former intern Internet Search School
Refe
rral from family member/acquaintance Other:
3
SECTION 3 – EDUCATION & TRAINING
Type of School
Name, City, State of
School
Type of Diploma/Decree
awarded
Major/Program
High School
N/A
College or University
Other School or
Training Organization
Computer applications with which you are comfortable working (check all that apply):
Microsoft Word
Microsoft Excel
Microsoft Access
Microsoft Power Point
Microsoft Outlook
Operating Systems:
Other applications:
Foreign languages spoken or read:
4
SECTION 4 – EMPLOYMENT/VOLUNTEER HISTORY
For each job/volunteer position you have had, provide the following information. Begin with your
most recent position. Feel free to attach additional pages as needed.
Most recent job/volunteer position
Job Title:
Employer Name:
Employer Address:
Name and Title of Immediate Supervisor:
Phone Number of Immediate Supervisor:
Dates of Employment:
From: To: Number of hours/week:
Description of duties/responsibilities:
Former positions:
Job Title:
Employer Name:
Employer Address:
Name and Title of Immediate Supervisor:
Phone Number of Immediate Supervisor:
Dates of Employment:
From: To: Number of hours/week:
Description of duties/responsibilities:
5
SECTION 5 – GENERAL INFORMATION
Are any of your relatives employed by the Circuit Court? Yes No
I
f yes, please list name and relationship of each relative:
A
ffirmative responses to the following questions will not automatically exclude you from
volunteering at the Circuit Court:
H
ave you ever been dismissed or asked to resign from any position? Yes No
I
f yes, please explain the circumstances:
H
ave you ever been convicted of a criminal offense? Yes No
I
f yes, please explain the circumstances:
I agree to the following and herby represent that all information provided by me in this application
is true and correct. If chosen as an intern, I will abide by the policies and procedures of the
Montgomery County Circuit Court.
S
ignature of Applicant: Signature Date:
PL
EASE MAKE SURE TO REVIEW THE ENTIRE APPLICATION FOR ANY ERRORS
OR OMISSIONS BEFORE SUBMITTING IT TO THE CIRCUIT COURT.
Submissions should be e-mailed to QCInternship@mcccourt.com
AN EQUAL OPPORTUNITY EMPLOYER
COMMITTED TO WORKFORCE DIVERSITY
P
lease be advised if you are under the age of 18 and you are offered an internship position,
you will be required to submit a Work Permit. You may obtain one by going to the following
website: https://www.dllr.state.md.us/ChildWorkPermit/web/content/Home.aspx
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VOLUNTARY INTERNSHIP APPLICATION Montgomery County Circuit Court 50 (Montgomery County Maryland)

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Completed 6 May 2021

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