The Healing Center Internship Application

The Healing Center Internship Application
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth (Optional)
Current School or University
Degree Program & Year of Study
Relevant Coursework or Certifications (Public health, social work, communications, media, trauma studies, spiritual care, psychology, counseling, etc.)
Previous Volunteer or Work Experience (Related to social services, counseling, community outreach, or trauma support)
Why do you want to intern at The Healing Center? (Briefly explain your interest in supporting survivors of sexual assault and the community.)
What skills or qualities do you believe you can bring to the role? (Describe your strengths or experiences related to counseling, community work, emotional support, etc.)
What do you hope to learn or gain from this internship experience? (Share your goals or what you hope to take away from this opportunity.)
How do you understand the importance of trauma-informed care, and why is it important for supporting survivors of sexual assault? (Demonstrate your understanding of trauma-informed practices or your willingness to learn about them.)
Preferred Start Date
Availability (Days and Hours per Week)
Duration of Internship (e.g., 3 months, 6 months, or school semester)
References (Provide 2-3 references who can speak to your character and qualifications, such as professors, previous employers, or volunteer coordinators.)
Reference Name, Relationship to Applicant, Email, and Phone Number
Confidentiality AgreementBy applying, I understand the sensitive nature of this work and agree to respect the confidentiality of the clients and their personal information.
Consent for Background Check (if applicable): I understand that a background check may be required as part of the application process.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year(By signing, you acknowledge that the information provided is accurate and complete.)
Should be Empty: