Internship Application

Internship Application NEW

First Name

Last Name

What are your pronouns?

Anticipated age at start date

Preferred Phone

What opportunity (or opportunities) are you applying for?

How did you learn of this opportunity?

What type of internship are you seeking?

Undergraduate

Graduate

Are you seeking a Clinical or Non-Clinical internship?

Clinical

Non-Clinical

Desired Start Date

Education Information

Highest level of education completed

Degrees earned

Are you seeking an internship placement for class credit?

Yes

How many semesters are required for your course requirements?

Who is your internship instructor or liaison?

Current place of enrollment

Current Major/Program

Hours needed

Licenses and Certifications

Languages spoken other than English

Employment Information

Current Employer

Current Position

Current Employer

Current Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Current Supervisor

Current Supervisor Phone

Current Supervisor Email

Volunteer History

Describe any experience you have working with youth aged 11-25 or any vulnerable populations

Describe any past volunteer experience that you have

Availability

How many shifts are you willing to work per week?

How many hours do you need to complete per week/per semester?

Previous Employer 1

Name

Relationship

Phone

Previous Employer 2

Name

Relationship

Phone

Previous Employer 3

Name

Relationship

Phone

Character Reference 1 (no relatives or family)

Name

Relationship

Phone

Character Reference 2 (no relatives or family)

Name

Relationship

Phone

I understand and consent to Pathfinders contacting my references.

Yes

Emergency Contact

Name

Relationship

Phone

Emergency Contact's Address

Address Line 1

Address Line 2

City

State

Zip Code

Attach a copy of your resume (PDF or Word Doc)

Upload Resume

I certify that all information provided in this application is true to the best of my knowledge.

I consent to having this website store my submitted information so Pathfinders can respond to my application.

Signature

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Today's Date

URL

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Internship Application

Education Information

Employment Information

Current Employer

Volunteer History

Availability

Previous Employer 1

Previous Employer 2

Previous Employer 3

Character Reference 1 (no relatives or family)

Character Reference 2 (no relatives or family)

Emergency Contact

Get Involved

Get Informed

Donation Drop-offs

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