Internship Application

Personal Information

* Indicates required field

Name *

First

Last

Date of Birth *

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Internship and School Information

What Intern Position Are You Applying For? *

What School Are You Applying From? *

Which semester are you applying for? *

Length of Internship *

Start Date: *

End Date: *

Do you need a set number of client contact hours? *

How many hours must be direct client contact? *

How Many Hours Do You Need Total? *

How Many Hours Per Week Do You need? *

SAFE's Office Hours are Monday-Thursday 10 AM - 3 PM. Will these hours accommodate your internship needs? *

Supervision Requirements

How Many Hours of Supervision Do You Need? *

Supervisors Credential Requirements *

Other Requirements from Supervisor *

Additional Information

How did you hear about our internship program? *

Why are you interested in our internship program and/or working with the military/first responder population? *

What Experiences Would You Like to Gain Through This Internship? *

What are your long term career goals? *

Is There anything else you would like to share about yourself? *

Please Attach Your Resume and Your Professional/Academic References

Upload File *

Max file size: 20MB

By typing my name in the box below, I authorize verification of all statements contained in this application for an intern position. I understand that this information is voluntarily supplied and may be used for SAFE purposes only and in connection with my intern status. I certify that this information is true and correct to the best of my knowledge and belief. If this application leads to internship placement, I understand that false or misleading information in my application or interview may result in my release.

Name *

Submit