Career Awareness Internship Application - 2019 The Career Awareness Internship is a program for Chicago youth (age 14 – 15) who have the motivation, perseverance, and resilience to acquire the necessary education and pursue a career. Acceptance into the Career Awareness Internship is competitive and requires completion of this application and an interview. Applications are due Monday, June 3 at 5PM. Good luck! Question Title * 1. First Name Question Title * 2. Last Name Question Title * 3. Contact Information Address * Address 2 City/Town * ZIP/Postal Code * Email Address Phone Number * Question Title * 4. Gender Question Title * 5. Race/Ethnicity African American/Black Hispanic Caucasian Two or more races Other (please specify) Question Title * 6. Birthdate Question Title * 7. Who do you live with? Name: Relationship to you: Question Title * 8. Last Completed Year in School 7th 8th 9th Question Title * 9. Which grade school do/did you attend? Question Title * 10. Which high school do/will you attend? Question Title * 11. Emergency Contact Name Phone Number Email Address Relationship to you Question Title * 12. How did you learn about this program? Question Title * 13. List 3 words your friends use to describe you 1. 2. 3. Question Title * 14. What are you passionate about? Question Title * 15. What are you good at? Question Title * 16. What are you proud of? Question Title * 17. On a scale of 1-4 are you: 1Never 2Once in a while 3Much of the time 4Always Adaptable Adaptable 1Never Adaptable 2Once in a while Adaptable 3Much of the time Adaptable 4Always Ambitious Ambitious 1Never Ambitious 2Once in a while Ambitious 3Much of the time Ambitious 4Always Friendly Friendly 1Never Friendly 2Once in a while Friendly 3Much of the time Friendly 4Always Funny Funny 1Never Funny 2Once in a while Funny 3Much of the time Funny 4Always Persistent Persistent 1Never Persistent 2Once in a while Persistent 3Much of the time Persistent 4Always Resilient Resilient 1Never Resilient 2Once in a while Resilient 3Much of the time Resilient 4Always Resourceful Resourceful 1Never Resourceful 2Once in a while Resourceful 3Much of the time Resourceful 4Always Respectful Respectful 1Never Respectful 2Once in a while Respectful 3Much of the time Respectful 4Always Self-Motivated Self-Motivated 1Never Self-Motivated 2Once in a while Self-Motivated 3Much of the time Self-Motivated 4Always Question Title * 18. List one of your personal goals for the summer. What are your plans to reach that goal? Question Title * 19. Describe a time in your life when you had to persevere. Describe the situation and what you did to keep going. Question Title * 20. What do you like to do for fun? Question Title * 21. What motivates you? How do you keep yourself motivated when life isn’t going the way you want it to? Question Title * 22. List two careers that interest you potentially. Explain why they each interest you. Question Title * 23. Brag about yourself. Why should we accept you into the Career Awareness Internship? Question Title * 24. 3 Favorite Subjects in School? 1. 2. 3. Question Title * 25. 3 Least Favorite Subjects in School? 1. 2. 3. Question Title * 26. For you school is generally Easy Hard Easy and hard (depending on the class) Question Title * 27. Do you have an IEP or 504 plan? (We WELCOME students with all types of learning styles! :)) Yes No Question Title * 28. If yes, what is your learning disability? Question Title * 29. If yes, what kind of accommodations (or help) do you need in the classroom? If you have any questions, please email Ama Appenteng at amaappenteng@companies-that-care.org or call 312-661-1010 Done