Cybis Production Internship App



	First			Last



	Mailing Address
	City			State	Zip
	Home Phone		Cell Phone		Email Address

Please note that you must have the full support from your adviser in order to be eligible to apply. They must be willing to support transportation, permission slips, waivers, and other special requirements that may be necessary in order to fulfill your duties, should you be selected. In addition, the selected student must be a registered attendee for the conference. Check here to affirm that you have discussed this opportunity with your adviser and they have agreed to endorse you I understand that the production internship likely begins prior to the first day of the event to support setup. This is mandatory and the best part of the internship. I understand I will be expected to join Cybis on the morning of the first day listed above. By checking here, I acknowledge I have also confirmed this with my adviser.
	School Name			Adviser Name
	Adviser School Phone		Adviser Home/Cell Phone		Adviser Email Address

	Organization Membership: First Year Second Year Third Year Fourth Year		School Year: Freshman Sophomore Junior Senior		GPA:

	Please list any state or national conferences you have previously attended:
	Please list and explain any relevant job experience:
	Please indicate any events that you will be participating or competing in at this conference:
	Please rate your experience in each of the following areas (1=no experience, 5=expert):
	1	2	3	4	5
						Event Planning
						Lighting/Stage Design
						Video Editing
						Stage Directing
						Studio Cameras
						Motion Graphics
						Still Graphic Design
						Audio Production
	What do you hope to gain through this internship opportunity and how does it relate to your career goals:
	Final thoughts? If you have an online resume or portfolio, please include its address here. (optional)