Internship Program Clarksburg High School
Sarah Costlow
Internship Coordinator
301.444.3557 (ofc.)
301.444.3000 (school)
301.4443595 (fax)
Application Packet
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Clarksburg High School
Internship Application Table of Contents
Name of Document
Internship Application Letter-Student page 2
Internship Parent Permission page 3
Internship Student Requirements page 4
Internship Application pages 5 - 6
Resume Sample page 7
Internship Counselor Form page 8
Faculty Recommendation Form page 9
Faculty Recommendation Form page 10
Application packet checklist page 11
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Clarksburg High School
22500 Wims Road Clarksburg, MD 28071 Phone: 301- 444.3000 Fax: 301 444.3595
2012 – 2013 School year
Dear Future Internship Student,
Thank you for your interest in the Internship Program. Internship is a program for high school seniors that
requires a semester or full year long commitment and allows students to explore their career interests, gain
valuable work experience, and earn credit toward their high school diploma. Rather than taking academic
classes during periods 5, 6, and 7, students in the Internship Program participate in a paid or unpaid internship
where they become actively involved in business, government, industry, research, or social services. Students
also participate in bi weekly seminars where they explore career and workplace issues.
In order to participate in the Internship Program, students must meet the following requirements:
- Students must complete the preliminary application process by February 24, 2012.
- Student must attend one Student Information Meeting: TBA (spring)
- Students must work independently and with the internship coordinator to have
an internship placement by July 30th
.
- Students must have no financial obligations.
- Students must have their own transportation.
- Students submit a time sheet signed by their sponsor (person mentoring or overseeing their work
experience) and keep a log of hours.
- Students must submit a weekly written reflection.
- Students must submit their own resume.
- Students must attend a bi weekly seminar at school
- Students must complete 75 recorded hours for each desired ½ credit.
To begin the application process, students need to complete the attached internship application packet and
return them to Ms Costlow, Room 213, by February 20th
, 2012.
Students must have two teachers complete the recommendation forms found in the packet and one counselor
recommendation and request that they return the form to Ms. Costlow’s main office mailbox.
Sincerely,
Sarah Costlow
Internship Coordinator
301-444.3557
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Clarksburg High School
Internship Parent Permission Letter
Dear Ms. Costlow,
I give my child, ______________________________________________________________
Print Name
permission to submit an application to be reviewed for the internship program. I have reviewed the internship
information packet with my child and understand what is expected of them if they decide to pursue the program.
I understand it is my responsibility to take an active role in helping my child to locate an internship site when
possible, and to reinforce the need for good work habits and attendance.
I can also assure that my child has transportation to and from the internship site.
_______________________________________________________ _______________
Parent Signature Date
______________________________________________________ _______________
Student Signature Date
This document is available in an alternate format, upon request, under the Americans with Disabilities Act, by contacting the Public Information Office, at 850 Hungerford Drive, Room 112, Rockville, MD 20850, or by phone at 301-279-3391 or via the Maryland Relay at 1-800-735-2258.
Individuals who need sign language interpretation or cued speech transliteration in communicating with Montgomery County Public Schools (MCPS) may contact
Interpreting Services in the Deaf and Hard of Hearing Program at 301-517-5539.
MCPS prohibits illegal discrimination on the basis of race, color, gender, religion, ancestry, national origin, marital status, socioeconomic status, age, disability,
physical characteristics, or sexual orientation. Inquiries or complaints regarding discrimination or Title IX issues such as gender equity and sexual harassment should
be directed to the Office of the Deputy Superintendent of Schools at 301-279-3126, via the Maryland Relay at 1-800-735-2258, or addressed to that office at 850 Hungerford Drive, Room 129, Rockville, MD 20850.
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Clarksburg High School
Internship Student Requirements
The Internship Program at Clarksburg High School offers an opportunity for students to pursue a career path, to
gain first-hand work experience, and to determine a career interest before graduation. Interns work in a
mentored, paid or non-paid position and attend regularly scheduled seminars. The internship can be inclusive of
a job placement the student already has. The intern chooses the career area of their interest and works with the
Internship Coordinator to find the most appropriate job site.
Requirements:
1. Must attend and participate in a weekly seminar on Mondays. Usually 5th
or 6th
period.
2. Submit a weekly reflection on Mondays via email or on paper.
3. Keep a time log.
4. Maintain a 3.0 or above grade average.
5. Complete a student Obligation of Participants form given out at the first seminar
6. Must complete 75 recorded work hours for each .5 course credit
a. 3 internship periods = 225 hours per semester in order to pass
b. 2 internship periods = 150 hours per semester in order to pass
c. 1 internship periods = 75 hours per semester in order to pass
7. Must arrange own transportation. MCPS does not provide transportation.
8. Students must sign out in the attendance office and leave school within 5 minutes after their last period.
9. Must complete a presentation on their internship at the end of each semester.
10. Cannot have financial obligation to any MCPS school.
11. Arrive at their internship every scheduled day.
12. Exhibit a professional work ethic.
Sarah Costlow, Internship Coordinator, Clarksburg High School
301-444.3557
Clarksburg High School, Room 213
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INTERNSHIP APPLICATION
Clarksburg High School
Name:_____________________________________________________________ Sex: M / F
(Last) (First) (M.I.)
Student #: _____________ Grade:_______ Age: _______ Date of Birth: Mo.___ Day___ Yr___ Languages spoken? _______________________________________________________________ Address: ________________________________________________________________________
(Street)
City___________________________________ Zip__________ Are you a US Citizen? Y / N
Home Phone _____________________ Cell Phone _________________ E-mail address _________________________________ Is this your Edline email? Yes / No Name of Parent(s) ______________________________________________ Phone _____________ or Guardian(s) ______________________________________________ Phone ____________ (Last) (First) (Work/Cell)
How many periods a day do you wish to intern? Check: Single Double Triple period
What periods? _________
Area of interest for internship: ________________________________________________________ Where you would like to intern? (If you know)
________________________________________________________________________________
Name/Phone Number of Supervisor(s) _____________________________________ Have you contacted places to see if they offer an internship in your area of interest? Yes No If so, where: _______________________________________________________________ What is your cumulative GPA? (unweighted) ____________
S1:_____ S2:_____
Ms. Costlow
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List any courses you have taken or experiences you have had related to your career area of interest:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Write why you are interested in becoming an intern.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
If you become an intern, the county does not provide transportation. How do you plan to get to
your internship on time every day?
________________________________________________________________________________
Return this form to Ms. Costlow rm. 213 Thank you.
301.444.3557
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Clarksburg High School
SAMPLE RESUME: FILL IN WITH YOUR DATA
Sample Resume: Fill out with your own information
*There is an electronic version of this template in Ms. Costlow’s Pd. 8 Handout Folder if it is helpful to you.
TYPE YOUR FULL NAME HERE
Type Your Address Here Type Your Phone # Here
Type your e-mail address here and make sure it is professional
Objective: To secure an internship in the field of _____________________
Education: Clarksburg High School, Clarksburg, MD: 2008 – present
Current Senior Cumulative Grade Point Average is: (add this information if it is positive or if your grades are particularly strong in the field you are seeking for example say “grade point average in technology related courses is
Related High School Courses:
(List all courses you have taken related to your internship)
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Work and Volunteer Experience:
Job Title, Name of Work Place; City, State, years or months employed there (ex: 2008-present) describe
your duties here in a few words.
Add another job here if you have or have had one. Jobs should be listed current or most recent first in
descending order.
Volunteer Activities can be listed in this same category in the following manner: (Job title or Name of the
Project You Worked On, Place you worked; City, State and # of hours, weeks, months or years
volunteered) Describe your duties and responsibilities here in a few words.
Special Skills and Other Qualifications:
Use different bullets to describe each of your computer skills, Internet skills, typing speed (if you know),
foreign languages spoken, license to drive and any other skills that would apply to the kind of internship
you’re seeking.
Xxxxxxxxxxxxxxxxxxx
Extra Curricular/Community Activities and Interests:
Use a different bullet to describe each school or community activity in which you participate. (If applicable
the amount of time you’ve been involved and any leadership positions held.)
Use a different bullet to describe each of your interests or hobbies
Honors and Awards:
Honor Roll
List any other awards you’ve received for your work at school or in the community,
For example: Eagle Scout Awarded June 2011
List things only for high school not middle school
Your resume should not exceed one page and references should be on a separate sheet of paper.
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Clarksburg High School
Internship Program Application - Counselor (To be completed by your counselor)
Counselor’s Name _____________________________________ Date __________
Qualifications: Grade Point Average unweighted ___________
Does the student have a history of excessive school absences? (Yes_____ No_____)
Does the student have after school obligations or activities that may interfere with the internship
schedule? (Yes_____ No_____)
Do you feel that this student will be able to meet the criteria to participate in the internship program? (Yes ______ No ______)
Comments:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Please return this form to Ms. Costlow’s office mailbox at your earliest convenience.
________________________________ ____________________
Counselor Signature Date
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Please Return to Ms. Costlow’s Office Mailbox Student Internship
Faculty Recommendation Form
Student: Last: __________________________ First: _________________________
Please Print
The above student has given your name as a reference on an application for admission to the
Student Internship Program.
Please return this form to Ms. Costlow at your earliest convenience.
In what class(es) or activities have you observed this student? __________________
Print Teacher Name: __________________________________________________
Comments:
Special Talents or Strengths:
Areas in which student may need special assistance:
_______________ _______________________________________
Needs
Help
Fair Average Good Excellent
Relating to others
Attendance
Punctuality
Cooperativeness
Personal Appearance
Expression of Ideas
Industriousness
Reliability
Scholarship (ability)
Initiative
Leadership Qualities
Page | 10
Date Teacher Signature
Please Return to Ms. Costlow’s Office Mailbox Student Internship
Faculty Recommendation Form
Student: Last: __________________________ First: _________________________
Please Print
The above student has given your name as a reference on an application for admission to the
Student Internship Program.
Please return this form to Ms. Costlow at your earliest convenience.
In what class(es) or activities have you observed this student? __________________
Print Teacher Name: __________________________________________________
Comments:
Special Talents or strong points:
Areas in which student may need special assistance:
_______________ _______________________________________ Date Teacher Signature
Needs
Help
Fair Average Good Excellent
Relating to others
Attendance
Punctuality
Cooperativeness
Personal Appearance
Expression of Ideas
Industriousness
Reliability
Scholarship (ability)
Initiative
Leadership Qualities
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Clarksburg High School
Internship Application Packet Checklist
Student Name: _________________________ ID#____________
Name of Document Completion
Internship Parent Permission □
Internship Application □
Resume □
Counselor Form □
(Counselor’s Name-_____________________________________________)
Faculty Recommendation Form □ (Staff’s Name-_____________________________________________)
Faculty Recommendation Form □ (Staff’s Name-______________________________________________)
□
All materials MUST be attached
prior to handing in your Application Packet (rm 213 or Ms. Costlow’s office mailbox)
Be sure you listed teachers/counselor who were given recommendation forms to return.
Thanks.