Internship Inquiry Form

Internship Inquiry Form

Please complete this form to help us learn more about your training needs and determine if this internship is a good fit.
Thank you for your interest in the Mental Health Counseling Student Internship Program with Deeply Rooted Mental Health Counseling. Please complete the form below so we can learn more about your training needs and determine if this internship is a good fit.
Full Name*

First NameLast Name
Email Address*
example@example.com
Graduate Program and University*
Current Program Year*
Is this for a practicum or internship requirement?*

PracticumInternshipOther
Required Supervision Frequency (e.g., weekly, bi-weekly)*
Anticipated Start Date*

MonthDayYear
Date
Briefly describe what you are hoping to gain from this internship*
Any additional information you would like us to know
Upload Cover Letter

Accepted formats: PDF, DOC, DOCX
Cancelof
Upload Resume

Accepted formats: PDF, DOC, DOCX
Cancelof
Disclaimer: This internship is intended for graduate level mental health counseling students completing practicum or internship requirements as part of an accredited academic program. This internship does not provide post graduate licensure supervision. Students are responsible for confirming that this internship meets their academic and program specific requirements.
Should be Empty: