Internships/Volunteers Application (Clinical)

Clinical Intern/Volunteer

Thank you for your interest in interning/volunteering with our organization! Cumberland County selects and accepts students for educational placement without regard to race/color, creed/religion, national origin, sex/gender, age, disability, religion, genetic information or pregnancy. The internship is for the benefit of the student and is not to be used in place of employees. Therefore, the intern will not receive compensation for time spent in the internship. While this program is intended for educational purposes the same procedures will be followed for volunteers.

Spring Semester (January-April):
Application due: 2nd Friday of September
Notified of Placement: 3rd Monday of October

Summer Semester (May-July):
Application due: 2nd Friday of March
Notified of Placement: 3rd Monday of April

Fall Semester (August-December):
Application due: 2nd Friday of June
Notified of Placement: 3rd Monday of July

Winter Semester (November-January):
Application due: 2nd Friday of August
Notified of Placement: 3rd Monday of September

Check out our website for the most recent list of colleges/universities that we are affiliates with. If you do not see your school, please contact Regina Williams, RWilliams@cumberlandcountync.gov or 910-433-6687 as soon as you hear from us that you were accepted as an intern to begin the affiliate process paperwork.

Thank you for your interest in working with our Organization!

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* 1. Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. What is today's date?

Date / Time

Date

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* 3. Please check which Category Applies to you.

Student: someone who is required to perform a given number of service hours in order to meet a school requirement.

Intern: someone who earns course credit for on-site work experience with the Health Department while attending a school of higher education.

Volunteer: someone who performs hours of service for the health department without promise, expectation or receipt of compensation for services rendered.

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* 4. In which Health Department Program/Area would you prefer?

Child Health

Maternity

Family Planning

Communicable Disease

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* 5. What Degree are you pursuing?

NP/PA

Clinical Administration

BSN/MSN/DNP

The normal working hours at the Cumberland County Department of Public Health are Monday-Friday, 8:00am-5:00pm. Ensure that the hours that you put in your total hours answer can be feasibly accomplished based on your availability AND your start/end timeframe.

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* 6. What are the total hours needed (if you have a requirement)

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* 7. What is your start date?

Date / Time

Date

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* 8. What is your end date?

Date / Time

Date

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* 9. What hours are you available? Check all that apply

8:00am-9:00am

9:00am-10:00am

10:00am-11:00am

11:00am-12:00pm

12:00pm-1:00pm

1:00pm-2:00pm

2:00pm-3:00pm

3:00pm-4:00pm

4:00pm-5:00pm

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* 10. How many hours a week can you commit to?

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* 11. What days of the week are best for you?

Monday

Tuesday

Wednesday

Thursday

Friday

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* 12. Why do you want to volunteer/intern at CCDPH? Include the professional development goals and objectives you seek to accomplish.

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* 13. Please attached your most recent Resume

Attachments should be in PDF or Word Document format

PDF, DOC, DOCX file types only.

Choose File

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100% of survey complete.