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* 1. Full name

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* 2. What is your email address?

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* 3. What is your phone number?

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* 4. What high school do you attend?

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* 5. What school year are you applying for?

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* 6. What is your grade level?

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* 7. Emergency Contact Information: Name and Phone Number

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* 8. Anticipated Hours per Week

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* 9. The internship runs the duration of the school year. Is this the type of  internship you are expecting? (yes/no) 

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* 10. Student Photo Release Agreement: Does Bethesda Green have permission to photograph the applicant for possible inclusion in a Bethesda Green publication or other publications for the purpose of promoting Bethesda Green?

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* 11. Electronic Signature of Parent: By executing this application below, I (we), parent(s) or guardian(s) of the applicant, confirm that I (we) are familiar with the purpose and activities of Bethesda Green (and requested additional information if desired), and do hereby authorize and consent to the applicant serving as a volunteer at and for Bethesda Green and do hereby for myself (or ourselves), for applicant, and for my (or our) heirs and assigns, waive any and all claims for damages or injuries I (we) or applicant may have against Bethesda Green, or any agent, employee, volunteer or representative of Bethesda Green (collectively, the “Indemnified Parties”), for any and all injuries or damages suffered by the applicant while on the premises of, or while participating in any activities of, Bethesda Green, and further agree to indemnify and hold harmless the Indemnified Parties from and against any claims whatsoever made in connection with applicant’s participation in any Bethesda Green activities I (we) understand that the applicant will not receive monetary compensation for any services contributed. By executing this application below, the applicant joins in the foregoing release and indemnity to the extent permissible pursuant to applicable law.

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* 12. Date

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* 13. Applicant Electronic Signature

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* 14. Date

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* 15. Waiver: MCPS Parent Acknowledgement of Virtual Internship (This section is only for MCPS parent/guardian): As the parent/guardian of an MCPS student, please read and initial that you have read and understand the following guidelines for a virtual internship.
  • Students must use personal/private accounts (not MCPS student accounts) to engage in the virtual platform.
  • Students will only engage with others under the direct supervision of a nonprofit supervisor. The nonprofit supervisor will be directly present in the virtual space (including any breakout sessions) at all times.
  • The nonprofit supervisor will initiate and host all virtual sessions. If the nonprofit supervisor is not available to initiate and host the virtual session, the session will not occur.
  • Virtual sessions will not be recorded.
  • Students should not share or upload any videos, pictures, or images of themselves, unless the nonprofit organization has obtained a signed form/waiver from the student’s parent/guardian authorizing permission/release. (Photo release is above)
  • Students’ email addresses/home addresses or any personally identifying information will remain protected and not shared

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