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Internship Application 2019-2020
dana.cook@colquitt.k12.ga.us
Room 207
* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Your Cell Phone
*
Your answer
Parents Cell Phone
*
Your answer
Is your possible internship on or off campus?
*
Choose
Off Campus- On campus
At CCHS- Yes
List the mentor (teacher/business) you are requesting to work with. - With
*
Your answer
List the mentor's business address if it is off campus
Your answer
List the mentor (teacher/business) phone or room number
*
Your answer
Join my Google Classroom - Class code epnrin
*
Yes I have done this
No- I need help and will come by room 207 for help
Required
I understand that I need to go to room 207 and pick up additional information and forms from Mrs. Cook
*
Yes I have done this
No - but I will do so
Required
Have you had any discipline issues at CCHS?
*
No
Tardies
Attendance
ISS
OSS
Other:
List any comments or concerns you have
Your answer
Submit
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