APPLICANT INFORMATION

Last Name* First Name* M.I.

Today's Date (mm/dd/yy)

Street Address* (street example: 2510 W WELLS) Apartment/Unit #

City* State* Zip Code* Aldermanic District

Phone* Current E-mail Address*

NOTE: You will be contacted by email. Please notify us if your email address changes.

Birth Date (mm/dd/yy)* You must be 16 by June 1, 2021 

Sex     Male  Female    

Are you a citizen of the United States?*  Yes  No     

If no, are you authorized to work in the U.S.?*  Yes   No

Were you ever a SYIP Intern, working in a City position?  Yes  No   

If yes, what department?

Have you ever been convicted of a felony?   Yes  No

If Yes, explain:

EDUCATION

High School* Address

From To Did you graduate? *   Yes  No     

#of Days Absent

Current Grade*   Freshman  Sophomore  Junior  Senior

GPA

PARENT OR GUARDIAN INFORMATION

Full Name Relationship

Address Phone with area code

PLEASE LIST A PROFESSIONAL REFERENCE

Full Name Relationship

Address Phone with area code

ADDITIONAL QUESTIONS

Cover Letter:* In the box below, or in a separate attachment, please introduce yourself, your background, and your career goals. Explain why you are interested in being an intern, and how your education and/or previous work experience make you a good fit for this internship. If you will attach your cover letter to the application, type “Attached” in the box.

Will you require any special accommodations during the interview process?*  Yes  No

If yes, what kind of accommodations will you need (i.e. a signer, a reader, extra time, other)?

Do you anticipate attending summer school?   Yes  No

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.  Yes  No

Electronic Participant Signature: (type your name):  * Date

To complete the application, click the Submit button below.

For more information, contact Vanessa Armstrong at (414) 286-6076 or email to: vaarmst@milwaukee.gov