Main Internship Application

Williamson County Children's Advocacy Center Internship Application
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Have you or a family member ever received counseling or assistance from the Williamson County Children's Advocacy Center?
If yes, when:
Internship Information
I am a:

Other
Which Internship are you applying for?
Which semester are you applying for?
College/University
Intern Semester/Year
Month/Year
Program/Major
Number of hours required to complete internship
Internship begins:

MonthDayYear
Date
Last day to accumulate hours:

MonthDayYear
Date
School/Teacher Contact

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Requirements of your on-site supervisor:
Please include your availability below. Regular business hours are from 8:00am to 5:00pm. The Therapy Department's hours are 8:30am-6:00pm.

If you are applying for a Therapy Internship these are the expectations:

* Graduate level Therapy Interns are expected to make a commitment of at least 20 hours per week. Availabilty on Wednesday morning is a requirement.

If you are applying for any other Internship, these are the expectations:

*Interns are required to commit 16-20 hours per week, in 4 hour increments on their selected days. (Ex: 8:00 AM to 12:00 PM or 1:00 PM to 5:00 PM).

Availability

References
References
I, {name}, hereby authorize the Williamson County Children's Advocacy Center (WCCAC) to contact professional/personal references listed on this form and understand that the WCCAC will not be held liable for the release of this information.
Signature
Should be Empty:

Williamson County Children's Advocacy Center Internship Application