Intern Intake Form
v2.3
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Congrats!
Welcome to the team. Please fill out this intake form to get you started. Allow for at least 20 minutes
Contact Info
Legal Name
*
First
Last
Nickname or name preference
Phone
*
Gmail Email Address
*
This MUST be a proper GMAIL.com email address. Not a yahoo, hotmail, .edu or ANYTHING else.
Contact Info (con't)
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Emergency Contact
*
Please provide your gmail address (copy and paste if same)
*
You will need a gmail account to communicate with the team via google hangouts
Internship Credits
Are You Expecting To Earn Credit for School?
*
Yes
No
If So, Do We Have The Checklist/Approval From Your Academic Advisor?
Yes
No
Please upload the file
Max. file size: 128 MB.
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Hours
If you need to change these hours, please notify your supervisor/manager .Please list all hours in EASTERN TIME ZONE
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Monday
Hidden
Tuesday
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Wednesday
Hidden
Thursday
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Friday
Hidden
Saturday
Weekends are not required. Only fill in these hours if you are planning to work on the weekends.
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Sunday
Social Links
Personal Facebook URL
*
Personal LinkedIn URL
Personal Instagram URL
Personal Twitter URL
List all other Social Media Links
Phone Work
Are you able to talk to clients/prospects on the phone?
*
We NEVER EVER do "cold calling", but there are times you may be asked to talk to clients or prospects. Please select what you are comfortable with below (Use your CTRL key to check all that apply)
Customer service
Technical support
Qualifying leads
Discussing services
Closing a sale
Calling cold leads
I don't feel comfortable with talking on the phone
Personality
Please visit this site and complete the free assessment.
16personalities.com
Then enter your information below:
Enter your personality type from the site above
*
Communications
Communication Comfort level
*
(Use your CTRL key to check all that apply)
Doing recorded video (you looking into camera)
Doing recorded video (you talking over a PowerPoint)
Doing Live video (Facebook Live)
Doing live teleseminar (phone)
Recording audio for presentations
Speaking to small groups (10 or less)
Speaking to medium-sized groups (10 - 50)
Speaking to large groups (50+)
I don't feel comfortable with public communication at all
Technology
What is your internet speed?
*
1-5 Mbps
5-10 Mbps
10-25 Mbps
25 Mbps+
Other Technology that you OWN or have IMMEDIATE access to
*
(Use your CTRL key to check all that apply)
Notebook Computer
Desktop Computer
Web Camera
Computer headphones/mic
Laser Printer
Color Printer
Scanner
iPhone
Android
Landline
HIGH Quality Camera
Tripod
Projector/Projector Screen
Travel
Are you able to travel if necessary?
*
From time to time, we do conferences around the world. Considering that your travel and lodging will covered, are you able to travel to events (3-4 days) at a time?
Yes
No
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