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Internship Application

  1. Office Seal Final

                    Internship Program Application

  3. Sex*

  4. Upload scanned drivers license here.

  5. Upload scanned medical insurance here.

  6. Any medical or physical conditions that would limit your ability to perform duties of an intern?*

  7. Is this internship a requirement for your major?*

  8. (required by school)

  9. Upload copy of resume.

  10. Upload copy of essay.

  11. Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my internship application.

  12. Westmoreland County Coroner
    2503 South Grande Boulevard
    Greensburg, PA 15601

  13. Leave This Blank:

  14. This field is not part of the form submission.