Internship

Supporting Kidds offers a variety of clinical internship opportunities supervised by Supporting Kidds clinical staff.

Internship Interest Form

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Name *

First

Last

Date of Birth *

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Education

High School

College & Major/Area of Study

Post Graduate

Other

Interest Area

Is there a person or group with whom you are particularly interested in working?

• Adults
• Teens
• Children
• Agency Staff

Availability

What time frame would you like to volunteer as an intern with Supporting Kidds?

Start Date

End Date

Days and Times Available

• Weekday mornings
• Weekday afternoons
• Weekday evenings
• Weekend mornings
• Weekend afternoons
• Weekend evenings

Total number of hours required to complete:

Credentials required of site supervisor:

References

1. Name *

Phone *

Email *

Relationship *

Years Known *

2. Name *

Phone *

Email *

Relationship *

Years Known *

3. Name *

Phone *

Email *

Relationship *

Years Known *

Submit