SBAPract Form 001

SCHOOL OF BUSINESS AND ACCOUNTANCY

INTERNSHIP APPLICATION FORM

PERSONAL DATA

NAME: ________________________________________________________S.N.: __________  

 
(Last Name) (First Name) (Middle Name)
MAILING ADDRESS:  _________________________________________________________  
             
#/street town/city zip code
AGE: ______ BIRTHPLACE: ___________________ SEX: _______ BIRTH DATE: _________  
 

NATIONALITY: ___________________ HEIGHT: _____________ WEIGHT: _______________  

EMAIL ADDRESS: ______________________________ PHONE NUMBER: _______________ 

 

COURSE: Accounting Technology

Business Management

FATHER'S NAME: ________________________ AGE: ______ OCCUPATION: ____________

MOTHER'S NAME: ________________________ AGE: ______ OCCUPATION: ____________

ACHIEVEMENTS (Include Awards, Scholarships, Special Recognition, or other College

Community Participation):

Activities Date Awards Received

               
   
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________   
             
 
              
        
TRAININGS/SEMINARS ATTENDED, if any:

Title Venue Date

             
               
    ____________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________     
           
             
       
               
   
WORK EXPERIENCE/EMPLOYMENT RECORD:

Have you work for any establishment/company?

Yes No

If yes, please indicate below:

Name of Firm/Company Position Date of Employment (From - To)

 _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
               
 
CHARACTER REFERENCES:

Name Profession Company and Telephone Number

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________ 
 
               
 

Answer the following:

What is the importance of a Practicum Program in my career?

                   
 
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________  
                   
 
                   
   
  How can I improve my personality through the practicum program?  
             
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
 
What are my office and computer skills?
 ____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
               

Recommended/Target Practicum Site:

Name of Company Contact Person/Position

Telephone Number
 ____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________    
         

This is to certify that all information in this form are true and correct.

           

SIGNATURE OVER PRINTED NAME:

DATE: