Internship Application

Internship Application Form
Name:

First NameLast Name
Please select the type if internship you are applying for:
Degree you are pursuing:
If selected other, please list degree below
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Email:
example@example.com
Graduate School:
If selected other, please list graduate school below
Name of University Field Coordinator

First NameLast Name
Email of University Field Coordinator
example@example.com
Projected graduation date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Safe Harbor Internship Application Process

Applications are accepted and reviewed upon submission. We are accepting Summer 2026, Fall 2026, Spring 2027 applications.
Semester you are applying to start
Fall 2026 semester is closed. Please enter a date for spring, summer, or fall 2027 semesters
Projected start date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearFall 2026 semester is closed. Please enter a date for spring, summer, or fall 2027 semesters
Please include your University deadline below
We cannot guarantee adherence to this deadline, but will take it into consideration during our review process.
Does your university internship include a group hour requirement?
Available for in-person scheduling?
Please select the following Maryland counties you would be willing to work from

Other
Internship Track

Safe Harbor's internship program has multiple tracks available according to clinical interest. Please indicate below which track you are interested in. For additional information on these programs, please visit our website. SHBC: https://www.safeharborbc.com/ SHCS: https://www.safeharborcs.org/
Safe Harbor Internship Track
Have you ever been released from an internship placement?
If so, please describe the circumstances below
Have you previously received services from a Safe Harbor counselor? (Please note: If you have been a past or are a current client, this will not effect our decision to move forward with placement. Special provisions would be made to protect your client information)

Other
Upload University Degree Requirements for Internship:

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Upload University Degree Program Description:

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Upload Cover Letter, Resume, and Curriculum Vitae:

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Upload Letters of Recommendation

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Internship Application Form

Safe Harbor Internship Application Process

Internship Track

Thank you for your application.