Chicago Zoological Society - Intern Application Form

*First Name:

*Last Name:

*Home Address:

City:

Country:

Zip:

*Contact Phone:

() -

*Email:

Academic Institution (if currently enrolled):

Current Academic Status:

Degree/Major:

Cumulative GPA on 4.0 Scale:

Specialty Applicants: (no assurance can be made about availability or placement):

Animal Care Specialist Applicants: Please choose up to 3 animal area preferences (no assurance can be made on availability or placement in these areas):

If you apply for Marine Mammal Care, you will only be considered for Marine Mammal Care.:

Marine Mammal Care

I am applying for the following term:

Fall (Sept. - Dec.)
Specialty: Animal Behavior (Jan. - June)
Specialty: Vet Tech Internship (Sept. - Dec.)

Gender:

Ethnicity:

Disabled/Veteran Status:

How did you hear about the C.E.L.O. program:

If Internet, which site?:

Failure to complete this form truthfully or as instructed, will result in disqualification. If you have any questions, please review the instructions found under Application Details on the intern website. Please initial:

Center for Conservation Leadership