Breakthrough Internship Network - Enrollment Form

Breakthrough Internship Network - Enrollment Form

Thank you for your interest in the Breakthrough Internship Network! By sharing your information below, you are confirming your interest in learning more about next steps to participate. If you have any questions, email

Laura Bahamonde - LauraBahamonde@breakthroughctx.org

Are you a Breakthrough student or have participated in Breakthrough Internship Network (formerly known as Future Focus) before?

I am a Breakthrough student and I HAVE previously participated in BINI am a Breakthrough student and have NOT previously participated in BIN

Student Name

If you do not find your name, it may be because we do not have an Email in file for you.

Email

MUST be Email on file may be your HS Email. If you don't recall please reach out to Laurabahamonde@breakthroughctx.org for support.

Birthday (MM/DD/YYYY)

What company did you intern with?

Preferred Name

Account Found

Primary Phone Number

Street Name

City

State

Zip Code

What college, university or program are you currently attending?

What is your classification this academic year?

Freshman (0-30 hcredit hours)Sophmore (30-60 credit hours)Junior (60-90 credit hours)Senior (90-120 credit hours)Not Currently EnrolledI am enrolled in a trade program (Skillpoint, IEC, Union Apprenticeship, Program Universal Technical Institute, Cosmetology program, ACC Cetificate program, etc)

What is your major or field of study?

Im here to (Select all that apply) :

Hold control down to select multiple

What Industries are you interested in?

Tell us about any special skills you may have (tech, second language, professional, etc.)

Are you interested in part-time (15-30 hours per week) or full times (30-40 hours per week) roles?

Part TimeFull TimeEither (Full time OR part time are fine)

What are your career interests

What is your current GPA?

We want to get to know you! Tell us a little bit about yourself, your background, and what you are hoping to gain from an internship experience/ how it would impact you.

Are there any specific host companies that you are interested in applying to?

Part Time Hrs Available

Are you interested in Full-time roles?

YesNo

Do you have a LinkedIn Account?

YesNo

Are you a KIPP or BT student?

KIPPBTA

Are you willing to relocate to a new city within the US for your internship?

YesNo

Are you a Dell Scholar?

YesNo

What Semester are you hoping to get placed?

Please provide an updated resume via the upload link below (Type of docs acceptable: .doc,.pdf,.svg,.docx,.dot, .json, .xlsx)

**If you do not have one feel free to use the following template to start it and upload it here. Don't worry about completing it all we will help with that! Just make sure it at least has your name and phone number**

By providing your phone number, you agree to receive text messages from Breakthrough Central Texas. Message & data rates may apply. Message frequency varies. Reply HELP for help and STOP to cancel. View Terms of Service and Privacy Policy.

I Agree

!!IMPORTANT!!

After you submit you MUST schedule a 1 on 1 with a BIN member. CLICK HERE to schedule your first meeting with BIN after submitting.

I will schedule my first meeting with a staff member after submitting this form