GRADUATE INTERNSHIP, FIELD, & TRAINEESHIP (GIFT) PROGRAM

ACKNOWLEDGEMENTS

By checking this box, the student confirms their understanding that this agency’s training requirements may exceed academic requirements. Graduate-level students should expect to complete 16-24 hours a week for a minimum of 9 months. For MFT trainees, traineeships extend up to 12 months.

By checking this box, the student confirms their understanding that a mandatory pre-practicum orientation and training must be completed prior to starting practicum. This training is typically 2 weeks in length and is held in mid-August.

By checking this box, the student confirms that the information contained in this application is true and correct.

Application

Last Name

First Name

Address

City, State, Zip

Cell Phone

E-Mail

Internship Information

Name of University

Address/Campus Location

Field or Practicum Advisor/Liaison

E-Mail Address:

Office Phone

Program

Which days are you available for practicum?

Monday

Tuesday

Wednesday

Thursday

Friday

What population would you like to work with next year as your first choice?

What population would you like to work with next year as your second choice?

Have you had a previous internship in the past?

Yes

If you answered yes to question #8, please list the site and population served.

Language Ability

What other languages(s) do you speak? If none, please move on to step 3.

- Speak?

Yes

- Read?

Yes

- Write?

Yes

Questions

What is your motivation for seeking an internship/practicum with this agency?

In terms of your career, where do you see yourself in 5 years?

What population (such as ages and/or diagnoses) are you interested in gaining experience with this year?

What diversity factors will you bring into this agency?

Tell us about your experience (or a family member's experience) with mental health service.

List any unique skills or abilities that you would like us to consider.

Resume Upload

Please submit a Microsoft Word or PDF version of your resume.

Demographics

ACKNOWLEDGEMENTS

By checking this box, the student confirms that the information contained in this application is true and correct.