Student Application

Students enrolled in an academic program with interest to intern at CDPH may complete this form. This allows CDPH to finalize prospective placement based on academic needs.

- Students must be enrolled in a university within Georgia to intern.

- Completion of this form does not guarantee an internship with Cobb & Douglas Public Health. Internships are offered based on departmental capacity.

- Due to the high volume of internship interest, only the students selected for an internship offer will be contacted by CDPH HR.

Name*

First NameLast Name

Date of Birth*

Enrolled University:*

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

CDPH Preferred Area of Focus:*

If offered an opprotunity with CDPH, what area of focus are you interested in?

If you selected "other", what university are you currently enrolled?

If you selected "other" for enrolled university, who is the internship coordinator for your university?*

Provide the email of the school contact that will be able to assist in coordinating your internship through your enrolled university.

Are you Enrolled in a University Outside of Georgia?*

YesNo

Are you Bilingual? (Optional)

YesNo

If yes, please list the language(s) spoken

First Date Available:*

Graduation Month/Year*

#of Hours Needed:*

You are seeking:

Were you referred by a CDPH employee?*

YesNo

Who referred you to our internship program?

What are your objectives in undertaking an internship with CDPH? (Optional)

Why would you benefit from an internship with CDPH? (Optional)

Upload Resume/CV (Optional)

Student Application

Internship Unavailable