APPLICATION FOR Name

CTE of
INTERNSHIP
Advisor:

Please complete this form in_______________________________

blue or black ink.
Submit all Applications to_____
Tami Rosage, Career Development Coordinator or
Denise Meekins, Career Development
Facilitator
Name of English
Teacher:
Applications due by April _______________________________
5, 2016

Applican
ts
Name:
Applican
ts Phone
#
Applican
ts E-Mail
Please list the Career
1.
Area(s) you are
2.
interested in
completing your
Internship in.
Check the boxes that match
your desired outcome
objectives for your CTE
Internship.
*(Every effort will be taken
to meet as many of your
desired outcome
objectives as possible,
however no guarantees
can be made.)

Objective 1: Complete the

CTE Internship
Objective 2: Earn SAT Hours through the CTE Internship

Objective 3: Complete the GRAD Project through the

CTE Internship

Total Number of days Absent during

last two semesters.
Overall (Unweighted) GPA
Can you provide your own
transportation to and from the
Internship site? Check one box.
Please specify which semester(s) you
wish to intern. *(You may select both.)

I have been absent _____________days during the

last two semesters.
My (Unweighted) GPA is:

YES

NO

FALL

SPRIN
G

SCHOOL RECOMMENDATION:
Please have a teacher, Guidance Counselor, or Principal sign below to indicate they
would recommend you for a CTE Internship.
I recommend this student for a CTE
Internship_____________________________________________________
Signature of School
Representative

_____/ _____/
_____
Date

ONSLOW CTE
INTERNSHIP
PROGRAM
COMMITMENT FORM
Applicants Name:__________________________________________ School: White Oak High
School
Applicants Printed Name
I, ____________________________________________________________, agree to abide by the follow
directions
Students Signature
if I am accepted into the CTE Internship Program during the 2016/2017 School year.
1. To consult with my Career Development Coordinator, Tami Rosage, and/or Career
Development Facilitator, Denise Meekins regularly regarding my Internship experiences.
2. To be regular in attendance and on time in my assigned Internship of 135 hours.
3. To notify my Community Sponsor and Career Development Coordinator, and/or Career
Development Facilitator on days that I will be absent.
4. To notify my Career Development Coordinator and/or Career Development Facilitator
should accident or illness cause me to be absent from my Internship more than three
times.
5. To notify my Career Development Coordinator or Career Development Facilitator should
any problems or concerns arise regarding my Internship.
6. To conform to the regulations of the organization in which I am working (dress, conduct,
etc.)
7. To understand that dropping this Internship after starting will result in my receiving a
failing grade unless there is due cause.
8. To inform parent(s) of Internship placement and experiences.
9. To complete the required online course curriculum, journal entries, Internship hours, and
End Of Course PowerPoint Summative Project associated with the CTE Internship Program.
10.To abide by any regulations, practices and procedures of the Onslow Career Focus
Internship Program of Onslow County Schools, not specifically stated above, as outlined by
the Career Development Coordinator and/or Career Development Facilitator.
11.To attend required off campus seminars whenever they are scheduled.
I have read and understand the conditions that my son/daughter/ward is agreeing
to. I understand that transportation is the responsibility of my student. I also
understand that a background and/or drug screening may be required at the cost
of my child and that TB screening and a Flu Vaccine is required for childcare and
medical placements.
Parent/Guardian
Signature:________________________________________________Date:__________________