St. Petersburg College Computer Technology Internship Program
Student Application 
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STUDENT NAME

E-MAIL DATE
LOCAL ADDRESS PHONE (H)
CITY STATE ZIP  PHONE (W)
MAJOR / CERTIFICATION
NO. OF HRS YOU CAN WORK DAYS AVAILABLE

BUSINESS TECHNOLOGIES COURSES COMPLETED CREDITS
TOTAL  
INDUSTRY CERTIFICATION TESTS COMPLETED

 WORK EXPERIENCE (Not necessary to complete if you have a resume)
 
ADDITIONAL INFORMATION / ACCOMMODATIONS
WOULD YOU CONSIDER AN UNPAID INTERNSHIP? Yes  No

I understand the above information may be shared with employers, students, staff and others involved with this internship program. By submitting this application, I am acknowledging that I have read and agree to the terms and conditions stated in the Student Manual.

The Board of Trustees of St. Petersburg College affirms its equal opportunity policy in accordance with the provisions of the Florida Educational Equity Act and all other relevant state and federal laws, rules and regulations. The college will not discriminate on the basis of race, color, religion, sex, age, national origin, marital status, sexual orientation, gender identity, or against any qualified individual with disabilities in its employment practices or in the admission and treatment of students. Recognizing that sexual harassment constitutes discrimination on the basis of sex and violates this Rule, the college will not tolerate such conduct.

Should you experience such behavior, please contact the director of EA/EO at (727) 341-3257 or (727) 341-3261 or by mail at PO Box 13489, St. Petersburg FL 33733-3489.

AS 505 (7/03)