Internship Application Form

Personal Information

Full Name

Email Address

Telephone Number

Current Address

Address Line 1

Address Line 2

City

Country

State

Provinces

State/Province

Postal Code

Citizenship

Date of Birth (optional)

Is your current address different from your permanent mailing address?

YesNo

Mailing Address

Address Line 1

Address Line 2

City

Country

State

Provinces

State/Province

Postal Code

Application Information

Term & Concentration Options

Which internship term(s) are you applying for? (please check all that apply)

Summer 2019Fall 2019Spring 2020Other

If "Other", what term(s) are you applying for?

It looks like you selected multiple terms, great! Please clarify:

I am interested in staying for multiple termsI just want to stay for one term, and am open to either selection

Please note the following start / end months for each term (see arocha.ca/internships for specific dates):

Spring: February - May
Summer: May - August
Fall: September - December

What internship concentration area are you most interested in? (please check all that apply)

Why Are You Interested?

Tell us a bit about why you want to intern at the A Rocha Brooksdale Environmental Centre. Please include what interests you about it and what you would hope to get out of an internship here:

Tell us a bit about why you feel you are a good fit for our internship program:

An internship at A Rocha is much more than work training – it includes living with others in community and sharing in a variety of tasks outside your program area (events, chores, meals etc). Please comment on your ability to be flexible and live and work with others from different ethnic, life, and faith backgrounds:

Attachments

Please attach a current resume (pdf or word format)

Please attach a current photograph

References

Please provide contact information for 3 references. Please choose a variety of references that will be able to speak to your work ethic, character, and ability to live within community. References should not be family members.

Reference 1

Name

Email

Telephone Number

What is your relationship to this person?

Reference 2

Name

Email

Telephone Number

What is your relationship to this person?

Reference 3

Name

Email

Telephone Number

What is your relationship to this person?

Other Information

Important Information

Please list any special dietary restrictions:

Please list anything that could impact your ability to be fully engaged in your internship (i.e., medical/mental health concerns, scheduling conflicts, etc.) for the entire length of the term:

Please comment on your ability to cover the cost of your stay: (Please note we are unable to provide bursaries or scholarships toward the cost of internship)

I will be able to cover the cost of my stayI have questions about covering the cost of my stayI am unable to cover the cost of my stay

Please elaborate on your questions here:

Please elaborate on your situation here. Please be aware that we are unable to offer financial assistance for the program:

Are there other special requests, questions, or things you would like us to know about you and / or your application?

How did you hear about us?

A Rocha Around the World

Please let us know if you would like to receive email updates from:

A Rocha Canada (monthly news & events from A Rocha across Canada and locally in BC)A Rocha International (periodic information from around the world - and from A Rocha in my country if they exist)

Please check if applicable

As an international applicant I give permission for this information to be added to the A Rocha International Volunteer Database and understand that the data may be shared with the A Rocha center in my home country (if applicable).

The details you supply will be stored by A Rocha Canada. All personal details will be stored in compliance with the Data Protection Act and will not be supplied to others without your permission.

	Very Interested	Somewhat Interested	Less Interested
Sustainable Agriculture
Conservation Science
Environmental Education
Food & Hospitality