Internship Application, Part 1

First Name*
Middle Name*
Last Name*
Name you prefer to be called
Interest, talents, and skills
I am Applying for*
PRODUCTION TEAM MEMBERS will be responsible for leading / co-leading specific disciplines and assisting in all aspects of the weekly production camp. The TEAM LEAD will oversee all aspects of performance training and final production on a weekly basis.
Please identify your areas of talent, skill, and interest. Select all that apply by holding down your ctrl key as you click (mac - command key)*
You will have opportunity to provide additional background information for your skill sets in Part 2 of the application. Thanks!

Personal Information
Date of Birth*
MM slash DD slash YYYY
Gender*
Marital Status*
Are you a U.S. Citizen?*
Please explain your current status*
Email*
Enter Email Confirm Email
Cell Phone
Home Phone*
Permanent Home Address*
Street Address City State ZIP Code
College mailing address (include P.O. Box)
Street Address Address Line 2 City State ZIP Code

Education
Name of school, city, state*

If this field does not apply to you, please enter "DOES NOT APPLY."
Field of study / degree program?*

If this field does not apply to you, please enter "DOES NOT APPLY."
Education*
If this field does not apply to you, please select "DOES NOT APPLY".

Health Questionnaire
IMPORTANT NOTE: Lamplight Artists' summer internship is a fantastic opportunity for personal growth and skill development, yet can be stressful at times due to the physical and emotional demands. Please complete the following health questionnaire.
Allergies?*
Please list allergies*
Are you currently taking any prescription drugs?*
List any prescription medications you are now taking:*
Do you have any medical condition that may hinder you on an unusually strenuous day with All About Kids Productions?*
Please explain*
Problems with sleeping, increased anxiety or depression?*
Please explain
Experiencing dizziness or fainting spells?*
Please explain
Epilepsy or other type of seizures?*
Please explain*
Diabetes?*
Please explain*
Have you ever been diagnosed with or treated for Bulimia, Anorexia Nervosa, or Compulsive Eating Disorder?*
Please explain*
Do you have any history of drug or alcohol abuse?*
Please explain*

Form verification
All answers are true to the best of my knowledge. I understand that purposefully providing false or misleading answers will be grounds for dismissal from the internship program.*

Please type your full name in the space above to acknowledge you have read and agree with this statement.

Congratulations! You have now completed Part 1. When you click the submit button below, you will be returned to the application home page to continue with Part 2.

Interest, talents, and skills