GCC Student Intern and Volunteer Registration Form

Application for Internships and Volunteer Opportunities
Thank you for your interest in volunteering with the Guidance/Care Center!

Please complete the application and submit all information requested. All personal data submitted by applicants is confidential.

Please consider what type of opportunity you would like to apply for:
- Internship: This is an academic opportunity and is typically geared for individuals that would like ongoing hands-on experience within our field of behavioral health and human services, working alongside our staff as we serve the individuals and families in our care.
- Individual Volunteers: These opportunities are typically for those who would like a one-time community service project such as organizing our donation closets, beautifying the grounds of our facilities, leading an art activity for those that we serve, or any other type of give-back for those that we serve! If you have a particular idea in mind we'd love to hear it!
The entire application takes just a few minutes and may take 5-10 business days to be processed. Don’t forget to click submit!

Please contact Guidance/Care Center at (305) 434-7660 ext. 31332 should you need additional information.
Full Name*

First NameMiddle NameLast Name
Date of Birth?*
mm/dd/yyyy
Gender Identified As

MaleFemaleDecline to state
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
E-mail*
example@example.com
How would you like to help?*

InternshipIndividual Volunteer
What type of opportunity are you interested in?*
School referring
Name of professor/ class
Major/field of study
Year in program
Are you a graduate student?
What type of supervision is needed?
ex. LCSW, BSW, MSW
Total number of required hours needed
Group name
How many in your group?
Age range of group members
Internship/ Volunteer Interests*

Mental Health & WellnessTreatment & RehabilitationVeterans ServicesCriminal Justice ServicesEducation & PreventionFundraisingAdministration/ClericalOther
Special skills (language spoken/read/etc)*
Have you ever been convicted of a felony?*
If yes, what was the charge?*
Are you a Veteran?*

YesNo
Military branch
From/to (date)
Rank at discharge
Type of discharge

Availability*

	Start time	End time	Other/notes
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Emergency Contact
Full Name*
Relationship*
Phone*
(xxx)xxx-xxxx
How did you hear about us? *
Is there anything else you'd like for us to know about you or ways in which you'd like to help?
Upload a document, such as a cover letter or resume.

Cancelof
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as an intern/volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
Signature*
Date*

MonthDayYear
Our Policy
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, sexual orientation, gender identity, marital status, age, or disability.

Thank you for completing this application form and for your interest in WestCare.
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Application for Internships and Volunteer Opportunities