Intern Application Form
Please complete this application form if you are interested in the internship program at the Potawatomi Zoo. Once you complete the form, click the Continue button at the bottom.
Contact Information
First name:
Last name:
Title:
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Dr.
Mr.
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Ms.
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Zip:
Home phone:
OK to call me here
Work phone:
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Cell phone:
Email address:
Permanent Address
Employer name:
First name:
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Middle name:
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Email address:
Relationship:
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Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
Demographic Information
You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.
Date of birth:
Month
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1917
*
Gender:
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Female
Male
Other
Prefer not to say
Race/Ethnicity:
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American Indian or Alaska Native
Asian
Black or African American
Caucasian or White
Hispanic, Latino, or Spanish Origin
Middle Eastern or North African
Native Hawaiian or Pacific Islander
Other
Prefer not to answer
Two or more
Preferred Pronouns:
Highest Degree Earned:
Internship Applying For:
Please state which internships you are applying for.
Season Applying For:
Please state whether you are applying for the Spring, Summer, or Fall intern session.
Interest
Why are you interested in an internship at the Potawatomi Zoo?
References
1
2
Employer name:
*
Employer name:
*
First name:
*
First name:
*
Last name:
*
Last name:
*
Title:
Choose
Dr.
Mr.
Mrs.
Ms.
*
Title:
Choose
Dr.
Mr.
Mrs.
Ms.
*
Street 1:
*
Street 1:
*
City:
*
City:
*
State:
Choose
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
*
State:
Choose
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
*
Zip:
*
Zip:
*
Home phone:
*
Home phone:
*
Cell phone:
*
Cell phone:
*
Email address:
*
Email address:
*
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
*
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
*
Contacted:
Choose
No
Yes
*
Contacted:
Choose
No
Yes
*
Verified:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
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1999
1998
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1996
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1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
*
Verified:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
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10
11
12
13
14
15
16
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19
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21
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28
29
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31
Year
2042
2041
2040
2039
2038
2037
2036
2035
2034
2033
2032
2031
2030
2029
2028
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
*
Employment
Please list your current or most recent employer.
Employer name:
Title:
Choose
Dr.
Mr.
Mrs.
Ms.
Street 1:
City:
State:
Choose
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
Work phone:
Criminal History
Please indicate below if you been convicted of a felony or, within the last 7 years, a misdemeanor crime? If yes, explain offense, date of offense, and place in which it occurred:
Cover Letter
Please enter your cover letter in the text box below.
Resume
Please enter your resume in the text box below.
Applicant Acknowledgement
I certify that the information in this application is accurate, current, and complete. I understand that misstatements or omissions may result in disqualification from further consideration.
I authorize Potawatomi Zoo to request, and I also authorize and request each former employer, school attended, and each person, firm or corporation given as references above to furnish at any time, any information which may be sought concerning me and my work habits, character or skill, and any other data required, whether in connection with this application or for purposes of complying with surety company requirements or otherwise.
I Agree
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