Internship Application Form
Name:
*
First Name
Last Name
Please select the type if internship you are applying for:
*
Please Select
Practicum
Internship 1
Internship 2
Foundation Year Field placement
Advanced field placement
Preceptorship
Doctoral Externship
Degree you are pursuing:
*
Please Select
MA Clinical Mental Health Counseling
MA Social Work
PMHNP
Other
If selected other, please list degree below
*
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email:
*
example@example.com
Graduate School:
*
Please Select
Bowie State University
Concordia University Irvine
Drexel University
Indiana University (IUPUI)
Johns Hopkins University
Lancaster Bible College
Liberty University
Marymount University
McDaniel College
Messiah University
Morgan State University
Regent University
Salisbury University
University of Maryland
Walden University
Stevenson University
Other
If selected other, please list graduate school below
Name of University Field Coordinator
First Name
Last Name
Email of University Field Coordinator
example@example.com
Projected graduation date:
*
-
Month
-
Day
Year
Date
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
Please Select
Spring 2026
Summer 2026 (start date in May)
Fall 2026 (start date in Aug/Sept)
Spring 2027 (start date in Jan/Feb)
Projected start date:
*
-
Month
-
Day
Year
Fall 2025 semester is closed. Please enter a date for spring, summer, or fall 2026 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?
Yes, it is mandatory
Yes, but not mandatory
No group hours needed
Available for in-person scheduling?
*
Yes, I am local to Maryland and can commute
Yes, but seeking a hybrid schedule
I am not local to Maryland but can commute
No, seeking a fully remote internship
Please select the following Maryland counties you would be willing to work from
Prince George County
Harford County
Baltimore County
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
Behavioral Care (SHBC) - Afternoon/Evening hours, Onsite/Virtual
Community Services (SHCS) - Daytime, weekday hours, Harford County office
School-Based Program - Daytime, weekday hours, Harford County office
DBT Program - 12 week commitment, 2 evening virtual hours weekly
Nurse Practitioner Program
Doctoral Externship
Have you ever been released from an internship placement?
*
Please Select
No, I have never been released from an internship placement
Yes, I have been released from a prior 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)
Yes, I have received services from a Safe Harbor provider.
No, I have never been a client of Safe Harbor.
Yes, I am a current client of Safe Harbor.
Prefer not to disclose
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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Thank you for your application.
We will review your application and reach out with further details. Any additional information can be sent to InternshipProgram@safeharborbc.com.
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