Internship Application

Thank you for your interest in Potter's House! In order to apply for an internship, you will need to provide some information about yourself, the names and contact information of 3 references, as well as answer some questions.

1. Please fill out the information below. *This question is required.

First Name

Middle Initial

Last Name

Email This question requires a valid email address.

Phone This question requires a valid number format.

Birthdate This question requires a valid date format of MM/DD/YYYY.

calendar

2. Address (Current Residence in AR) *This question is required.

Address

City

State

Zip

3. During what time of year are you wanting to intern?

What program(s) are you interested in interning with? *This question is required.

Wet Cement Pre-School
Small Group Leader
Leadership Development (7th-12th grade)

Unsure, need more information
Other, please specify Please enter an 'other' value for this selection. * This question is required.

What internship position are you interested in? *This question is required.

Wet Cement Pre-School
Small Group Leader
Leadership Development (7th-12th grade)

Adult Program
Unsure, need more information
Other, please specify Please enter an 'other' value for this selection. * This question is required.

4. Are you applying for an internship through an organization or for class credit?

Please enter an 'other' value for this selection.

5. Please specify the type of internship you are seeking.

NOTE: If you are seeking an internship for class credit, it must be unpaid.

6. Have you volunteered with Potter's House before?

Please enter an 'other' value for this selection.

7. If you have already spoken or corresponded with a Potter's House staff member about an internship opportunity, please provide the staff members name below:

Please enter an 'other' value for this selection.

8. Please provide any helpful information on your schedule/availability (e.g. best days/times or times that you are not available) *This question is required.

9. Do you have any experience working with children or teens? *This question is required.

Where did you work and what did you do? *This question is required.

10.

Please tell us why you are interested in becoming an intern at Potter’s House.

*This question is required.

11. How did you hear about Potter's House? *This question is required.

12.

What strengths do you possess that will assist you during your internship experience?

*This question is required.

13.

How do you hope to grow or learn through this internship experience?

*This question is required.

14. Tell us a little about your family.

15. Please list 3 references: *This question is required.

Space Cell	Name	Email	Phone	Relationship
Personal Reference #1 (cannot be a family member)	Personal Reference #1 (cannot be a family member): Name	Personal Reference #1 (cannot be a family member): Email	Personal Reference #1 (cannot be a family member): Phone	Personal Reference #1 (cannot be a family member): Relationship
Business/Professional Reference	Business/Professional Reference: Name	Business/Professional Reference: Email	Business/Professional Reference: Phone	Business/Professional Reference: Relationship
Another Personal or Professional Reference (cannot be a family member)	Another Personal or Professional Reference (cannot be a family member): Name	Another Personal or Professional Reference (cannot be a family member): Email	Another Personal or Professional Reference (cannot be a family member): Phone	Another Personal or Professional Reference (cannot be a family member): Relationship

16. Please provide some information on your educational background.

Current or completed college degree (if applicable)

Minor (if applicable)

Master's Degree (if applicable)

Anticipated Graduation Date (Month & Year) *This question is required.

If you have any questions or issues with this application, please contact kelsey@phnwa.com.

Internship Application

Potter's House Intern Application