Fellowship Application

Applicant Contact Information

First Name

Last Name

Date of Birth

Phone

E-mail address

Street address

Street address 2

City

State

Zip code

School Information

School Currently Enrolled In:

School Office Phone No:

Years in School (as of Today):

Freshman	Sophomore	Junior	Senior	Graduate

Major:

Grade Point Average:

Cover Letter

Please briefly explain why you are interested in a fellowship with Supervisor Hagman's Office at the County Government Center in San Bernardino.

Resume

Availability

Please submit days and times you are available to work.

Reference #1

Name

Phone

E-mail address

Reference #2

Name

Phone

E-mail address

Reference #3

Name

Phone

E-mail address

Signature

By selecting the Checkbox below, you acknowledge you have read the message and agree with what is stated.
I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT ANY FALSE INFORMATION ON THIS APPLICATION MAY BE GROUNDS FOR DISQUALIFICATION AS A FELLOWSHIP CANDIDATE. APPLICANTS MAY BE ASKED TO COMPLETE A BACKGROUND CHECK AS PART OF THE APPLICATION PROCESS.
I Agree

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