Project Break Free Internship Application Form

Breathe Initiative
Internship Application

Thank you for your interest in the Breathe Initiative Internship! The application process includes two phases: the internship application and an interview. Please complete the application below and we will get back to you shortly. Please contact Betsy (bsambrano@kyccla.org) if you have any questions regarding this application or internship opportunity.

Name:*

First Name Last Name

Phone Number:*

Area Code Phone Number

E-mail Address:*

Birthday:*

Date

Which internship are you applying for?*

Health AdvocacyMedia and CommunicationsOpen to discussing options

If you are applying for the Media and Communications internship, please email 1-3 pieces of sample work to bsambrano@kyccla.org

How did you hear about this internship?:*

Are you currently enrolled as a college student?*

YesNoNot yet, but I will soon.

If yes, what college do you attend?*

I am able to commit at least 60 hours total.*

YesNo

What do you hope to gain from this internship opportunity? *

Upload Resume *

Upload Cover Letter (Optional) :

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