Intern and Leadership Program Application (Ages 12-14)

MHG Pre-teen and teen Intern and Leadership Program is designed to empower tomorrow's leaders with real life experiences.

First Name *

Last Name *

Date of Birth * +

Address (Street) *

City/State *

Zip *

Email Address *

School Currently Attending *

Current Grade *

Other Work Experience (babysitting, paper route, etc) *

Accomplishments and Honors (school activities, awards, certificates, volunteer work) *

References (please provide 2 references; name, phone number, e-mail)

	-	Phone	Email
Name	-	Phone	Email
Name	-	Phone	Email

What brings you to apply for an internship/leadership program with MHG? *

Availability

How many hours are you looking to intern? *

What do you want to learn from your experience? *

Signature *

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Date * +