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Operation Intern Student Eligibility/ Enrollment Form
Please type all of the following information:
* 1. Where will your internship take place? (Please list business/company name):
* 2. First Name:
* 3. Last Name:
* 4. Birth Date:
5. Address 1:
* 6. City:
* 7. State (abr. - drop down)
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
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OR
PA
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TN
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UT
VA
VT
WA
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* 8. Zip Code
* 9. Phone:
* 10. Email Address
* 11. Nationality/citizenship:
* 12. Internship job/position title:
* 13. Please provide a description of your career goals and how an internship/work experience opportunity with a North Dakota business or employer will help support your goals.
* 14. I have completed one semester of college.
yes
no
* 15. I will be earning academic credit for this experience.
Yes
No
* 16. School:
17. Degree and Major or High School:
18. Date of High School Graduation:
19. Date of Expected College Graduation
* 20. College Faculty Supervisor (if in college):
* 21. Email Address:
* 22. Internship/work experience area of interest:
* 23. I am a US Citizen or Permanent Legal Immigrant and am attending a North Dakota Institution of Higher Education.
I certify
24. How did you hear about this internship?
* Spam Check
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