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HELLO THERE! Please complete all questions indicated with the (*) for The Intern Program opportunity.

Please Note: Your current or past circumstances, including any history of incarceration, does not automatically determine your eligibility for the opportunity(s) offered. We simply ask that you answer all questions honestly and to the best of your ability. Please note that incomplete applications may result in disqualification.

Intern Application

First name*

Last name*

Address*

Apt., Suite, Unit

Birthday*

Month

Day

Year

Best Way To Contact You. Please Check All That Apply:*

Email

Phone

Email*

Phone*

How Did You Hear About Us?*

Website

Social Media

Referral

Other

Why are you interested in SistaH of SurvivaL? (Please be specific)*

Have you ever been arrested?*

Yes

No

Have you ever been incarcerated?*

No

Yes (list time served & where?)

How long have you been out (list days, months, years or N/A)?*

Are you on probation?*

No

Yes (for how long?)

Gender Identity*

Female

Male

LGBTQ+

Prefer Not To Say

You Identify As:*

Hispanic or Latino

Not Hispanic or Latino

You Also Identify As:*

Black/African American

White

Black/African America & White

American Indian/Alaskan Native

Asian

Native Hawaiian or Pacific Islander

Other

What languages do you speak?*

English

Spanish

Other

What is your Microsoft Office Suite computer literacy level?*

Beginner

Intermediate

Advanced

Not Familiar with the Suite

Do you have any of the following devices (Please check all that apply)*

Mobile Phone

Laptop

Desktop Computer

iPad/Tablet

Please list which software tools and programs you are proficient in*

Do you have experience working or volunteering with a Non-Profit Organization?*

No

Yes (indicate years & experience below)

Which semester timeframe(s) are you applying for? (Please select all that apply)*

Fall (September thru December)

Spring (January thru May)

Summer (June thru August)

List the maximum number of hours per week you are willing to commit to:*

How many hours are needed per semester to complete the practicum?*

Which intern opportunity are you interested in?*

Do you have any experience or coursework related to domestic violence or non-profit work?*

Yes

No

We often go out to visit shelters & attend events. Do you have reliable transportation?*

Yes

No

What area of social work are you focused on (i.e. homelessness, education, family, healthcare, etc.)? Type N/A if none*

What research or data analysis experience do you have? Type N/A if none*

If selected, what do you hope to gain from your internship with us?*

Based on your personal experience and/or professional studies, what can you bring or offer SistaH of SurvivaL?*

Please upload your resume*

By typing my name below, I affirm that all information provided in this application is true and accurate to the best of my knowledge. I understand that entering my name electronically serves as my official signature.*

Signature*

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Would you like to join or mailing list?

Yes, subscribe me to your mailing list.

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