National Black Growers CouncilSummer Internship Program Application Survey

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.

Question Title

* 1. Type Full Name:

Question Title

* 2. Enter Date of Birth:

Date / Month / Year:

Date

Question Title

* 3. Type Mailing Address:

Question Title

* 4. Type Permanent Mailing Address:

Question Title

* 5. Type Phone Number:

Question Title

* 6. Type Email Address:

Question Title

* 7. Type Emergency Contact Person:

Question Title

* 8. Type Emergency Contact Person's Phone Number:

Question Title

* 9. Type Emergency Contact Person's Email Address:

Question Title

* 10. Do you hold a valid U.S. driver's license?

Yes

Question Title

* 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.)

Yes

Question Title

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

Question Title

* 13. Academic Classification: (Select One)

Question Title

* 14. Select College / University currently attending:

Question Title

* 15. Major / Field of Study:

Question Title

* 16. Please list relevant coursework completed.

Question Title

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

Agribusiness / Agricultural Economics

Agricultural Engineering / Mechanics

Agricultural Technology

Agronomy / Soil Science

Animal Science / Aquaculture / Fishery Biology

Biotechnology

Crop Science / Production / Farm Management

Environmental Sustainability / Regenerative Agriculture

Food Science

Forestry / Natural Resource Management

Horticulture

International Agriculture

Question Title

* 18. Why are you interested in pursuing an internship in agriculture?

Question Title

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

Question Title

* 20. What are your career goals in the agricultural industry?

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.

Question Title

* 21. Resume and References:

Question Title

* 22. Acknowledgement:

I acknowledge that the information provided is true and accurate to the best of my knowledge.

Question Title

* 23. Type Signature:

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.