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Submit for an Internship

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Steps

1. Applicant Information This section is complete This section is incomplete
2. Voluntary Demographic Data Survey This section is complete This section is incomplete

Applicant Information

First Name
Last Name
Street Address
City
State
Zip Code
Phone Number
Email Address
Year of Graduation
Major
Minor (If Applicable)
Areas of Interest
1. Body Art- Tattoos & Piercing
2. Communicable Disease
3. Emergency Preparedness
4. Epidemiology
5. Finance/Grants
6. Food Safety
1. Health Education and Promotion
2. Housing
3. Mosquito Control
4. Policy
5. Public Health Nuisances
6. Rabies-Animal Bite Investigation
1. Recreational Water- Pool & Spa
2. School Inspections
3. Solid Waste- Trash
4. Statistical Analysis
5. Tobacco Use Prevention and Cessation
Professional References
(Minimum of Two)
Reference 1 First Name
Reference 1 Last Name
Reference 1 Phone Number
Reference 1 Email Address
Reference 2 First Name
Reference 2 Last Name
Reference 2 Phone Number
Reference 2 Email Address
Desired Duration for Internship
Desired Duration for Internship Start Date
—
Desired Duration for Internship End Date
Would you accept a non-paid internship?
1. Yes
2. No
Attach Your Resume
Continue

Voluntary Demographic Data Survey

We appreciate your assistance and ask that you provide the following (optional) information.
Gender
1. Male
2. Female
3. Other
If other, please list:
Race / Ethnicity
Please select all that apply.
1. American Indian or Alaska Native
2. Asian or Asian American
3. Asian Indian or Asian Indian American
4. Black or African American
1. Hispanic or Latino
2. Native Hawaiian or Other Pacific Islander
3. White
4. Other
If other, please list:
Age Group
1. 18 to 29
2. 30 to 49
3. 50 to 69
4. 70 or Older
Disability
1. Yes - Disabled
2. No - Not Disabled
Thank you for your participation!