Name*

First Last

Date of Birth

Address*

Street Address City State ZIP

Phone*

Email*

What's the best way to contact you?*

Phone
Email

Social Security Number*

I agree to provide my Social Security Number.

Your social security number is necessary in order to work with protected species. You must provide your SSN on the first day.

College/University*

Major*

Career Interest*

Semester you wish to start the internship*

Spring
Fall
Summer

Disabilities (learning, physical, mental, etc.)*

Medical Conditions, including allergies:*

Date of last tetanus shot:*

Are you currently employed?*

Yes
No

Employement

Company Name

Supervisor's Name

Supervisor's Phone

Supervisor's Email

Advisor Information

Advisor/Professor overseeing the Internship Independent Study*

First Last

Advisor/Professor phone*

Advisor/Professor email*

In case of emergency

Emergency Contact Name*

Emergency Contact’s phone*

Emergency Contact’s relation to you*

How did you hear about the Operation WildLife Internship Program?*

Experience or skills that you think will be of benefit to the organization:*

What do you expect to learn from your internship with OWL?*

Have you volunteered and/or worked with wildlife before? If so, where?*

Have you ever been convicted of a felony? If yes, what for?*

Consent*

I agree to the privacy policy.

I have read, understood, and agree to the requirements
asked of me within the internship program for OWL
and understand that neglecting to do any of these
requirements will be reflected in my grade for college
credit or any references that are asked for from
Operation WildLife, Inc.

Signature*

First Last

Date*

OWL Code of Ethics and Professional Conduct

I agree to the Code of Ethics.

Read Here

Operation Wildlife Waiver for Interns and Volunteers

I agree to the Waiver for Interns and Volunteers.

Read Here

Internship in Kansas

Employement

Advisor Information

In case of emergency