2017 Williams Michael Dively 61 Internship Application
2017 WILLIAMS MICHAEL DIVELY ’61 INTERNSHIP APPLICATION
Today’s Date: ______Application Deadline: 04/28/17
Name______Class______
Major______Concentration ______
E-mail______SU Box ______Phone ______
Name of Organization______
City______State______Country______
Supervisor______Supervisor’s Title: ______
Supervisor’s E-Mail ______Supervisor’s telephone number ______
Organization Web Address______
If you are receiving assistance in the form of a stipend from your internship sponsor what amount? ______
Have you applied for Summer Travel/Research Fellowships, CES grants, Linen funding, Mellon Mays
Undergraduate Fellowship (MMUF), the Allison Davis Research Fellowship (ADRF), etc.? Please list below.
______
______
Please note: If you accept any other Alumni Sponsored Internship Program Grantfrom Williams College for
any projects during the summer of 2017, you are not eligibleto receive the Dively Grant.
In order to be eligible for the Dively Grant, currently enrolled first-years, sophomores and juniors must be in
good standingwith Williams College. The $3,800 Dively Grant is considered taxable income.
Please highlight the industry/field that best describes your sponsoring organization:
Arts (Fine & Performing)
Children/Youth/Education
Community Building/Renewal
Computers/Technology
Consumer Protection
Crime/Safety/Prison Reform
Disabilities
Disaster Relief
Economic Development
Elder Issues
Energy Conservation
Entertainment
Environment
Family /Parenting
Farming/Agriculture
Foundations/Fundraising
Gov’t/Public Policy
Health, Mental or Public
Housing/HomelessnessHuman Rights/Civil Liberties
Immigration
Job Training/Workplace Issues
Journalism
Law
Peace/Conflict Resolution
Poverty /Hunger
Race /Ethnicity
Recovery/AddictionAbuse
Religion/Spiritual Issues
Social Entrepreneurship
Veterans Affairs
Voting/Democracy
Wildlife/Animal Welfare
Women's Issues
Other ______
In addition, you are required to submit a resume and an acceptance letter from your internship supervisor.
The acceptance letter from your internship supervisor must confirm that you will be working full-time
(35-40 hours per week) for at least eight weeks. Your internship supervisor should tell us how
your work during the summer would benefit their organization. If you experience any setbacks in acquiring this letter, please email Dr. Patterson-Stephens for further assistance: .
Please submit your application packet (your resume, the 2017 Dively Application, your responses to our supplemental questions and a letter of acceptance from your internship supervisor) in pdf format to Dr. Patterson-Stephens: sps3@williams. You may also print the materials and submit them to her office in Jenness House.
______
Signed Date
2017 WILLIAMS MICHAEL DIVELY ’61 INTERNSHIP APPLICATION – SUPPLEMENTAL QUESTIONS
Please answer the following questions: (2 pages double-spaced max, in total for all questions):
How would you use the Dively grant money?
How would your internship/fellowship relate to your academic and co-curricular interests?
What personal objectives do you wish to achieve as a result of this opportunity?