Internship Application Form

Internship Application Form

Any question please email us at info@ihahealthcare.com
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
How did you hear about us?*
University
Type NA if you are not a student
Degree program
Type NA if you are not a Student
Accumulative GPA
Omit if you are not a student
Do you have access to a personal computer or other equivalent technology for use during your internship? (Your answer to this question will not affect your eligibility as an applicant - we only ask to be prepared)*

YesNo
Program Applying To
During which term(s) are you interested in an internship with us? (Check all that apply. You will be considered as an applicant in every cycle that you select here.)*

Fall 2025Winter 2025Spring 2026Summer 2026Fall 2026Winter 2026
Why do you want to be a part of this internship or program? *
Why are you a good fit for this internship or program? *
Why should you be selected over other applicants?*
What is a strategy you use to help you handle stressful situations?*
Tell me about a time where you successfully collaborated with others. *
Our staff and community volunteers are committed to ensuring that your program is safe, professional, and fun. It is important that participants, faculty, and staff understand and agree to the following IHA community expectations: We expect all our students and staff to act with respect towards each other. Intolerant, disrespectful, or disruptive behavior towards others will not be tolerated and could result in dismissal from the program. Your relationship and communications with our staff, fellow students, and any community volunteers should be strictly professional. As professionals in a medical environment you are expected to abide by HIPPA guidelines and are not to share any patient photos or confidential information with anyone, including on social media. We expect our community members not to misrepresent their identities or their personal/professional records. our agency IHA reserves the right to remove any applicant or student from the registration/admissions process and program for engaging in, or having engaged in, conduct that faculty or staff determine violates this code of conduct or otherwise negatively impacts the learning environment. The cancellation policy will be applied in these instances. If you have any questions or need further clarification, please reach out to a member of our program staff. I have read and agree to all the items above*

Yes
Resume

Cancelof
I agree to terms and condition provided by the company. By providing my phone number, I agree to receive text messages from the business.

Yes
Should be Empty: