Burlington International Airport
Intern Application
Full Name 	Birthdate	/	(Month and Date Only)
Day Time Phone Number_____________________  Email:____________________________
Address
City	State	Zip	
Emergency Contact Name	
Relationship To Emergency Contact	
Emergency Contact: Home Phone	Work Phone	

I certify that am over 18 years of age

Yes_____ No______ 

If no, parent/guardian must sign below.

I,	(name) give my permission for	
to work as a BTV AIRPORT INTERN. I am this intern’s (relationship)	
____________________________
Signature

Please return this application along with resume and cover letter to:
Burlington International Airport
1200 Airport Dr. #1
Burlington, VT  05403
Or email: slosier@btv.aero

1.	Please indicate the days and times that you are available.

	Time Available	
Monday		
Tuesday		
Wednesday		
Thursday		
Friday		

2.	Do you have any upcoming vacation/time off that we need to be aware of?
_______________________________________
3.	Do you have health insurance?
Yes______	No______
If yes, please complete below:
Provider:_____________________________
Policy No:____________________________
4.	Do you have any special skills or interests that might be useful to the BTV Airport Intern Program which you would be willing to utilize for the Program? If yes, please list: