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In order to be eligible for NYCIntern housing, you must either be or have been a full-time college student within the past 12 months. You must also be engaged in a full-time internship during your time in housing. How did you hear about NYCIntern housing? Friend College Internship Department Employer Internet Other Referral Name/Web Site (Optional) Personal Information First Name Last Name Address 1 Address 2 City, State/Province, Zip/Postal Code , AB AK AL AR AZ BC CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MB MD ME MI MN MO MS MT NB NC ND NE NH NJ NL NM NS NT NU NV NY OH OK ON OR PA PE PR QC RI SC SD SK TN TX UT VA VI VT WA WI WV WY YT NA Gender Male Female E-Mail Address Home Phone ()-- Cell Phone ()-- College Attending or Attended Internship Coordinator at College (if applicable) Term of Internship Spring 2009 (January 9 - May 2) Name Email Office Phone ()-- Company Providing Internship Name of Company Name of Contact Address of Company City/State/Zip , AL AK AZ AR CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY NA Email of Contact Office Phone ()-- Type of Apartment Requested: 4-person, $5400 per person for January 9 - May 2 3-person, $6950 per person for January 9 - May 2 NYCIntern also charges a $500 deposit that will be refunded at the end of your lease period if your apartment is left clean and without damage. Comments or Names of Any Preferred Roommates: Desired Additional Services Gym Membership ($250 for the Semester) An application fee of $50 must be received in order for us to consider your application. Use the form below to make this payment, using Visa or MasterCard. Name (As it Appears on Credit Card) Credit Card Address (Must Be the Billing Address of Credit Card) City/State/Zip , (Billing Address) Card Type MasterCard Visa Card Number (Please enter your number without spaces or dashes. For example, enter your number as: 1234567845627891. Not as 1234-5678-4562-7891 or as 1234 5678 4562 7891) Expiration Date 01 02 03 04 05 06 07 08 09 10 11 12 /MM 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 /YY Amount $50.00
In order to be eligible for NYCIntern housing, you must either be or have been a full-time college student within the past 12 months. You must also be engaged in a full-time internship during your time in housing.
How did you hear about NYCIntern housing? Friend College Internship Department Employer Internet Other
First Name
Last Name
Address 1
Address 2
City, State/Province, Zip/Postal Code
, AB AK AL AR AZ BC CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MB MD ME MI MN MO MS MT NB NC ND NE NH NJ NL NM NS NT NU NV NY OH OK ON OR PA PE PR QC RI SC SD SK TN TX UT VA VI VT WA WI WV WY YT NA
E-Mail Address
College Attending or Attended
Internship Coordinator at College (if applicable)
Name
Email
Office Phone
()--
Company Providing Internship
Name of Company
Name of Contact
Address of Company
City/State/Zip
, AL AK AZ AR CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY NA
Email of Contact
Type of Apartment Requested: 4-person, $5400 per person for January 9 - May 2 3-person, $6950 per person for January 9 - May 2
Desired Additional Services
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