Research Volunteer Application

Please complete this application form if you are interested in becoming an Institute of Noetic Sciences intern. Once you complete the form, click the submit button at the bottom.

Contact Information

First name:

Last name:

Middle name:

Street 1:

Street 2:

City:

State:

* Zip:

Country:

Home phone:

Cell phone:

Email address:

Web site:

Additional Information

Date of Birth:

(year optional)

Gender Identity:

Education:

Major Degree:

Minor Degree:

School:

Languages:

Current Occupation:

Resume/LinkedIn:

Project Preferences

Interests

What interests you about an internship at IONS? What skills would you like to develop? What would you like to learn more about?

Needs

What do you need from IONS in order for this internship to be worthwhile for you? If interning as part of a school program, what is required by your school?

Skills

Time Commitment

My availability is:

From:

to:

I would like to assist up to:

hours:

How many hours per week or month can you spend working on IONS projects, and for what period of time (specify dates)?

Emergency Contact Information

First name:

Last name:

Cell phone:

Email address:

Relationship:

References

Please provide two professional and/or academic references.

1

2

Employer name:

First name:

Last name:

Street 1:

Street 2:

City:

State:

Zip:

Work phone:

Cell phone:

Email address:

Relationship:

Release of Liability & Confidentiality Agreement

I am offering my services to the Institute of Noetic Sciences (IONS) in a volunteer capacity.

In my role as a volunteer, I acknowledge that I am not an employee or agent of IONS. Accordingly I am not covered by IONS Worker's Compensation or medical insurance benefits. In the unlikely event that I should be injured while volunteering my services, I hereby assume and shall bear the entire risk of loss for any personal injuries resulting from my volunteer activities.

I shall not disclose privileged or confidential information to unauthorized parties, and understand that all information procured for, created by, or on behalf of the Institute of Noetic Sciences (IONS) is the property of IONS and shall not be transferred or utilized except on behalf of IONS, and I will use it in compliance with IONS' policies and procedures.

By checking below, I accept and agree to the above Release of Liability & Confidentiality Agreement.

I Agree

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