Internship Application Form
(NOTE: Parental Consent Form is required for Interns under 18 years of age.)
Have you volunteered or interned with us before? If Yes, when and where?
How did you hear about us (select all that apply)?
Are you currently a student?
Is your intern experience education related?

Is your intern experience credit-based? If Yes, include # of credits.
Note: The internship has to be for academic credit or offered through the school's program.
Are you interested in a remote intern opportunity?
If Yes, are you able to complete your assignment using the basic essentials, such as your personal computer, internet connection, phone, email, etc.?
Are you currently working?
Have you spoken to the intern site coordinator about the position? If Yes, include name and department.
Days available to intern (select all that apply) *
Times available to intern (select all that apply) *
How many hours can you commit? *
For our record, have you ever been convicted or had adjudication withheld in a criminal offense, or are there any criminal charges pending against you? (Note: A conviction or adjudication withheld will not automatically disqualify you from volunteering with Pinellas County.) *

Acknowledgement Statement *
* Your e-mail address is required to submit this form. E-mail addresses are public records under Florida law and are not exempt from public-records requirements. If you do not want your e-mail address to be subject to being released pursuant to a public-records request, do not send electronic mail to this entity. Instead, contact this office by telephone (727-464-8477) or in writing, via the United States Postal Service to this address:
Pinellas County Volunteer Services
400 S. Fort Harrison Ave, 1st Floor, Suite 111
 Clearwater, FL 33756