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Internship Application

Lancaster County Emergency Management Agency

Internship Opportunity Application

The collection of information may be used to obtain information from organizations and individuals pertaining to your character, education and current and/or prior employment as may be relevant and necessary to determine your fitness and suitability for acceptance into the Lancaster County Emergency Management Agency Internship opportunity.

There are 21 questions in this survey.

Personal Information

Name (Last, First, MI)

Home Address (Street, City, State, Zip Code)

Email Address:

Phone Number:

Educational Background and Goals

Please provide information regarding your education, academic institution, and your internship learning goals.

Academic Institution

Please list the school, College, or University where you are currently enrolled.

Academic Program

Please list what academic program you're enrolled in (Emergency Management, Public Health, Data Science, etc.).

Academic Program Contact Info

Please provide the name and contact (email or phone) of your academic program contact

Learning goals.

Please discuss your learning goals/objectives. Is there a specific area of focus you'd like to emphasize if selected for an internship?

Do you have a project proposal?

Yes
No
No answer

Please drag your domain interest to the right column in order of preference.

The goal is to find projects which most closely match your interests.

All your answers must be different and you must rank in order.

Please select at most 6 answers

First choice
Choice of rank 2
Choice of rank 3
Choice of rank 4
Choice of rank 5
Choice of rank 6

Your choices

Data science (working with mass data collection, analysis and systems development; GIS applications, BI)
Training and Exercise (Regional training and exercise development)
Health and Medical Preparedness (public health, hospital and healthcare, veterinary, and agricultural planning)
Operational Readiness (EOC planning, and systems management)
Community Resilience and Engagement (working on live projects with external stakeholders, including volunteer management)
Planning and Administration (Working to review, update plans with external agencies)

Your ranking

Please provide your propose project information.

Prior Emergency Management Training and Experience

Prior pertinent Emergency Management training and/or experience.

Please list any/all prior Emergency Management training or experience.

Other Relevant Skills

Please list any specialized skills or experience you consider relevant to your internship experience.

Other relevant skills

Please list any other relevant skills you may consider important for your internship. This may include software expertise, medical or veterinary skills, administrative skills or background, etc.

References

Reference 1

Please enter a name, and preferred contact information (email address or phone number) for your reference.

Reference 2

Please enter a name, and preferred contact information (email address or phone number) for your reference.

Reference 3

Please enter a name, and preferred contact information (email address or phone number) for your reference.

Attachments

Please upload any supporting documents such as a resume, cover letter/interest statement, and/or PA State Police background check.

Background Check

Please upload a copy of your PA State Police Criminal Background Check.

Please upload at most one file

Upload file

	Title	Comment	File name

Resume/CV

You may upload a resume or CV with information you feel relevant to your potential selection.

Please upload at most one file

Upload file

	Title	Comment	File name

Other

You may upload information such as a cover letter or project narrative you would like submitted with your application.

Please upload at most one file

Upload file

	Title	Comment	File name

Consent

By typing my full name above, it constitutes consent and authorization to the disclosure or furnishing of any relevant and necessary information or records to any duly authorized official acting on behalf of the County of Lancaster or the Lancaster County Emergency Management Agency for any person, corporation, agency, or association concerning my character, employment, education or military service as may be relevant and necessary for a determination of my suitability for volunteer status and may include reference checks, ACT 34, Childline, FBI, and criminal background investigation. It is in my interest to permit such investigations to take place by Lancaster County Officials and, therefore, in consideration of my desire to have all of the material considered, I hereby authorize Lancaster County Officials to make such inquiries.

I certify that all information provided in this document and any accompanying documents is accurate, correct and complete. I understand that falsification or misrepresentation or omission of any facts in said documents will be cause for denial of acceptance into the LEMA Internship opportunity

The reverse of this form lists reasons for which acceptance may be denied. If, after being accepted into the program, I subsequently become subject to anything on this list, I will immediately notify the County Emergency Management Director.

It is understood that I shall make no claim against the person or persons furnishing information and shall make no claim against any firm, organizations, agency, or Lancaster County for providing or reasonably using any information.

The release of any information desired is respectfully requested and authorized with my full understanding and endorsement.

Please type your full name to consent. If you do not consent, please exit the survey now.

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