Vermilion County Conservation District
Forest Glen County Preserve
20301 East 900 North Road
Westville, IL 61883

Application for Internship Program

Year                 

A. Personal Information:   Social Security #
Name:
Address:
City: State: Zip:
Phone Number:    
Drivers License # Class of License:
   
B. Education:    
Name and Location Attended Graduated
High School:__________________
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College: ____________________
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Curriculum:
Trade, Business or Correspondence School:
 
C. Former Work Experience: (List most previous first)
From (Mo./Yr.)  To (Mo./Yr.) Name and Address of Employer Reason Left
1.    
     
2.    
     
3.    
     
4.    
     
D.  During which time period are you available for?
Summer Session (12 wk.) Fall Session (6 wk.) Winter Session (6 wk.)
     
     
E. References: (General)    
Name Address Occupation
1.    
     
2.    
     
3.    
     
Signature:   Date: