Derby Internship Application

The KESMARC KY Internship can be very physically, mentally, and emotionally demanding. Before making a commitment to KESMARC KY, please ensure that you will be able to honor that commitment.

Name *
Address *
Phone *
Date of Birth *
Date of Birth
Are you currently under a doctor's care or have you previously been treated for any medical condition/injury/illness that can impact your ability to perform your duties as an intern or that can place you at increased risk during he performance of those duties? If yes, please describe:
Do you have any allergies? If yes, please list:
What is your country of citizenship?
Do you have a high school diploma? If yes, when did you graduate?
Please list all post-secondary schools you have attended. Include name of school, location, area of study, years attended, gradation date/projected graduation date, degree obtained.
Please describe your work experience and general information regarding subjects of personal study/research and/or special training/skills.
Please describe your equine experience.
Please list breeds you have worked with.
Please describe any other extracurricular activities or interests.
Please describe any honors or awards you have received.
Will you bringing a car?
Why should you attend the KESMARC KY Internship?

Correspondence regarding the internship may be conducted via mail, phone, or email. Please add KESMARC KY's email address to your Address Book so that you will receive all correspondence.