Thank you for your interest in NBGC’s Summer Internship Program. This program offers hands-on agricultural experience for students attending an 1890 Land Grant historically Black college or university. Please complete the application to be considered.

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1. Type Full Name: (Required.)

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2. Enter Date of Birth: (Required.)

Date

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3. Type Mailing Address: (Required.)

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4. Type Permanent Mailing Address:

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5. Type Phone Number: (Required.)

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7. Type Emergency Contact Person: (Required.)

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8. Type Emergency Contact Person's Phone Number: (Required.)

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9. Type Emergency Contact Person's Email Address:

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10. Do you hold a valid U.S. driver's license? (Required.)

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11. Do you have any medical conditions, allergies, or health concerns that may require accommodations during the internship? (Any medical information you provide will be kept confidential and used only as necessary to ensure your safety and well-being.) (Required.)

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12. If you answered "Yes" to the previous question, please explain:

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13. Academic Classification: (Select One)

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14. Select College / University currently attending: (Required.)

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15. Major / Field of Study: (Required.)

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16. Please list relevant coursework completed. (Required.)

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17. Select Area(s) of Interest in Agriculture: (Check all that apply) (Required.)

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18. Why are you interested in pursuing an internship in agriculture? (Required.)

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19. How do you plan to share the knowledge you've gained from your internship, and with whom will you share it? (Required.)

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20. What are your career goals in the agricultural industry? (Required.)

Please Note: If you're selected as an intern, you will be expected to develop a fact sheet, present your research or share your experiences at model farm field days, conferences or other workshops.

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21. Resume and References: (Required.)

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22. Acknowledgement: (Required.)

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23. Type Signature: (Required.)

The National Black Growers Council is committed to protecting your privacy. Your data is only used for processing your application and
communicating with you regarding the internship. NBGC ensures your data is protected from unauthorized access.

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