Member Internship Application

SEIU Local 1021’s Internship for Leader Development is looking for energetic and motivated members who are committed to working for social and racial justice, believe in the value of work, the democratic process, and the importance of public services. This program will train and mobilize members who want to unleash their leadership potential.

If you share these values and want to have an active role in your union, this internship is for you.

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* 1. First Name

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* 2. Last Name

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* 3. Employer

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* 4. Personal Email

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* 5. Cell Phone

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* 6. Home City

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* 7. Preferred/Primary Language

English

Spanish

Cantonese

Tagalog

Arabic

Other (please specify)

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* 8. Other language

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* 9. Do any of these circumstances apply to you which may make securing Union release challenging? Select all that apply:

Your dept. or classification is presently understaffed.

You have a medical condition that restricts your ability to drive, walk or be mobile.

Other people in your job classification or in your dept. are currently on extended leave.

You are or maybe facing an investigation and/or discipline at work.

You are having a conflict with your superiors who grant leave requests.

Your contract does not provide for Union release time.

Your contract does not provide for extended leave of any kind.

You have duties as a Union officer/steward/bargainer etc. that cannot be delegated to anyone else at this time.

Other (please specify)

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* 10. I have read the program requirements, I have the following restrictions:

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* 11. How proficient are you with technology? Scale 1 to 10 (1 low proficiency, 10 high proficiency

1 Low Proficiency

10 High proficiency

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 12. Why are you interested in this internship?

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* 13. Why are you passionate about unions and social justice work?

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* 14. What do you hope to get out of this program?

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* 15. What type of support are you hoping to get from the supervisor of this program?

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* 16. How did you hear about this internship program?

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* 17. Please include a sponsorship letter from a chapter leader or field representative

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