LOS ANGELES MULTICULTURAL INTERNSHIPS
Intern Selection Form
Organization
Name of Organization
Getty Marrow Internships at Los Angeles Organizations
Summer 2021
Name of Primary Supervisor
Phone Number
E-mail
(primary supervisor must be full-time paid employee at organization)
Name of Internship (as described on your application form)
Name and Phone Number of Person to contact regarding Intern Selection
(if different from primary supervisor)
Intern Candidate Information
Please provide the following information about your intern candidate, and attach a resume or curriculum vitae.
Last Name
First Name
Middle Name
Permanent Address
City
State
Zip Code
Phone
E-mail (please include email address where they can be reached over the summer)
With which of the underrepresented groups does the candidate identify?
A African American Asian
Latino/Hispanic
Native American
Pacific Islander
Other
Is the intern candidate: Male Female Other Is the intern candidate either a resident of or student in Los Angeles County?
Yes
No
Name of College or University Intern Candidate Currently Attends
Major
Has the intern candidate completed at least one semester of college by June 2021?
Is the intern candidate eligible to be legally employed at your organization?
Yes
Anticipated Month and Year of Graduation
Yes No No
What is the intern candidate's country of citizenship?
Has the intern previously served as a Getty intern at your organization? Yes
No
Is the intern candidate a staff member or relative of a staff or board member of your organization or the Getty Trust? Yes No
Briefly describe the intern candidate's qualifications:
Describe the recruitment and selection process, number of applications received, and criteria used to evaluate applicants:
Proposed start and end dates for the internship (10 consecutive weeks) beginning no sooner than June 7 and ending no later than August 27, 2021:
Start Date:________________________________End Date:________________________________
Have you chosen an alternate candidate in the event your first choice is unable to accept the internship? _ Yes
No
If yes, please provide name below:
Last Name
First Name
Middle Name
Deadline to submit this form and the applicant's resume or curriculum vitae for approval prior to hire: May 17, 2021. Please
scan and upload the completed forms into Fluxx () into the Information on Proposed Intern report form.
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