Internship/Practicum Application

Please use this form if you would like to seek a Student Internship/Practicum opportunity at the Linn County Sheriff's Office.

Phone
This field is for validation purposes and should be left unchanged.
Identification
Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Social Security Number (SSN)*
Driver's License Number*
State of Issue*
Contact Information
Home Address*
Street Address Address Line 2 City State ZIP Code
Email Address*
Home Phone*
Mobile Phone
Additional Information
Current Occupation
Have you ever been arrested for any criminal offense?*
- no
- yes
Please explain the circumstances of your arrest:
Internship/Practicum Information
Area of Study in College and Graduation Year
Skills, Training, or Experiences You'd Like to Share
Hours Required for Internship/Practicum
If None, Specify Zero
If this internship is outside your primary field of study, please explain your reason for applying.
Signature and Certification
Certification*
I have read the entire text of this application and understand it completely. The statements I have made are correct and true. I understand that making false statements on this application is a crime. If I have made false statements in this application, I am subject to prosecution and my application will automatically be denied or revoked.
- I certify that I intend my electronic signature on this application to be the legally binding equivalent of my traditional handwritten signature.
Signature*
Enter your full legal name.
Date Signed*
MM slash DD slash YYYY

Identification