1 Start 2 Complete First Name Last Name Application Date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20162017201820192020 Birthdate: * Please enter your date of birth. Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year191819191920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019 Are you older then 18 years old? Yes No Ethnicity: Please select the ethnicity you most identify with, please feel free to select more than one. Asian or Pacific Islander Black or African American Cape Verdean Haitian Hispanic Native American White/Non-Hispanic Other Address: Please enter your home/residental address. Gender: Male Female Transgender Other City: State: Zip: Phone Number: * Email: * School: Major: GPA: Advisor Info Name: Email: Phone Number: Emergency Contact Name: Relation: Phone Number: If you would like to inform us of a handicap, disability or medical condition you may have, please do so here: Why do you want to work with Boston Neighborhood Network? Desired Position: * Please select which department you would like to be placed in. Administration (Finance) Assistant Engineering Assistan Marketing/Membership Assistant Multi-Media Lab Assistant TV Production Assistant Radio Production Assistant Music Assistant Proficiency and ExperienceWhat is your proficiency and experience with the following: Video Camera Operations: Final Cut Pro: Adobe Photoshop/InDesign: Switchboards: Studio Lighting: Microsoft Office: Social Media: Computer Engineering/IT: What additional skills, talents or past experiences do you bring to BNN? How would you like to most contribute to BNN? What skills do you hope to gain experience in while working with BNN? AvailablityPlease provide us with your availability. Session Interest: * Please select which session you are interested in interning with us. - Select -SummerFallSpring Start Date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20162017201820192020202120222023 End Date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20162017201820192020202120222023 Amount of hours each week: BNN is open Monday-Friday 9 AM - 9:30 PM and Saturdays, 10 AM - 3 PM. Please fill in the hours you are available to work.Please enter your response in this format: Day (X:00 AM/PM - X:00 AM/PM) Monday: Tuesday: Wednesday: Thursday: Friday: Saturday: Is there any additional information you'd like us to know? Yes No Please provide us with additional information: ReferencesPlease list two recent professional or academic references:Reference #1: Name: Company: Title: Relation: Phone Number: Email: Reference #2: Name: Company: Title: Relation: Phone Number: Email: DocumentationPlease submit a RESUME AND COVER LETTER (include which position you are applying for in your cover letter) Add a new file * Files must be less than 2 MB.Allowed file types: gif jpg jpeg png psd pdf doc docx pptx xls xlsx mov mp3. By signing, I agree that to the best of my knowledge the information I have provided is correct. * Please sign your name. Date Signed: * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20162017201820192020 Parent/Guardian Signature * Because you are 18 or younger, we will need a Parent/Guardian's signature.