Internship Intake Form - LOHUM Foundation

Registration Form for LOHUM’s Summer Internship Program

Intern's name *

First

Last

Intern's date of birth *

Name of School

What grade is the Intern in? *

You can mention the last grade the Superhero was enrolled in.

What are your core subjects?

Please mention all the subjects you are taking this year.

What domain interests you most?

Eg. Marketing, Finance, Research, Electrochemistry, Computer Science, CSR etc. Please note all topics for the internship will be relating to sustainability.

Why would you like to intern with LOHUM? *

If you prefer a video answer you can email it to subuhi.safvi@lohum.com

How will interning at LOHUM aid your career goals? *

What are your short term and long term goals? *

Short term – 6-12 months Long term – 1-5 years

Recommendation letter *

Please provide a recommendation letter by one of your teachers. You can email a PDF copy of the letter along with the teacher’s name and subject to subuhi.safvi@lohum.com

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Phone *

Acknowledgement from Parents *

To the best of our ability, LOHUM will ensure the safety and well-being of your child. However, due to unforeseen circumstances, we request you to give your consent below. I understand that the risks associated with the internship activities could result in injury to my child. I hereby assume these risks and, knowing them, hereby give my child permission to participate. In the event of illness, injury, and/or accident, I authorize the employees of the LOHUM Foundation to act on my behalf. I permit the LOHUM Foundation to use images and videos of my child, taken during the internship, for the website, social media and any marketing collateral. I understand that the company may, in its sole discretion, dismiss any intern for inappropriate, disrespectful, or dangerous behavior at any time.