Organization Information

Organization Name

Organization Address

Transportation

Is your office accessible by public transportation?

If yes, by which BART/AC Transit Lines

Cost of travel around the Bay Area has increased over the years and can be a barrier for interns to work in person. Does your organization provide transportation stipends for interns?

Supervisor Information

Supervisor First Name

Supervisor Last Name

Supervisor Email

Supervisor Phone

Supervisor Title

Pronouns

Is the proposed intern supervisor a full-time staff member?

Will this supervisor work directly with the intern?

If no, please provide the contact information of the staff member (name and email) who will work directly with the intern:

Description of supervisor’s job and role in your organization.

Internship Description

Internship Title

Agency Description: Describe the program(s) the intern would be working with. Include each program’s mission, description of the population served, and all program activities.

Work Schedule: Outline the proposed work schedule for an intern. Indicate whether there are mandatory days when the intern would be needed.

Skills: Please describe the skills and qualities that an intern working with your program should possess.

Student Learning: List at least three skills that the intern might learn about Social Justice, Direct Service, Organizing, or Policy/Legislation while in this position.

How many interns would you like/be able to host at your organization?

The PSI team will do our best to honor the number of interns you request, however due to capacity we cannot always guarantee multiple interns for each site.

Intern Responsibilities

In the spaces below, break down the intern’s time to describe the general job categories or projects the intern will be responsible for. Below each category, please use the space to specify the individual duties and activities associated with each responsibility. The percentage of time spent on all categories should add up to 100%.
Important to note: We aim to place interns with organizations focused in the areas of Direct Service, Organizing or Policy/Legislation. Below duties should relate directly to those areas of focus and not be clerical in nature (minor clerical responsibilities are acceptable as part of the overall internship. The majority of the role should be project based and in-person as we aim to provide internships that are hands-on and experiential to their learning.

Intern Duties #1

Category

Percent of Time (%)

Description

Intern Duties #2

Category

Percent of Time (%)

Description

Intern Duties #3

Category

Percent of Time (%)

Description

Intern Duties #4

Category

Percent of Time (%)

Description

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More Information

How did you hear about this program?

Would you like to receive a monthly email of service and leadership opportunities, scholarships, and more?

Yes

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