Internship Interest Form
Thank you for your interest in internship opportunities with the Larimer County Department of Health & Environment. If an opportunity becomes available, we will contact you. We encourage you to also check www.larimer.gov/jobs for internship opportunities with our department.
Full Name
*
First Name
Last Name
E-mail
*
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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-
Area Code
Phone Number
School you are currently attending
*
Type of education program you are currently enrolled in:
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Please Select
Undergraduate
Graduate
Masters of Public Health
Traditional BSN
Non-traditional BSN
Masters in Nursing Education
Nurse Practitioner Program
Other Nursing Program
Other
If other please specify.
Highest level of Education Completed
*
High school
Some college
Undergraduate degree
Master's Degree
Other education or professional licensure
If you currently have a degree, what is it in?
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Please specify primary area of study, degrees, education, or professional licensure
*
How long of a commitment will you make?
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How many hours do you need to fulfill?
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Is this a specific school program requirement? Which one?
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Capstone
Practicum
Other
None
When will you graduate?
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Month
-
Day
Year
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Are you proficient in any language other than English? Please specify
*
What program area are you interested in?
*
Please Select
Clinical Services
Maternal Child Health
Emergency Preparedness
Health Education/Communication
Zoonotic Disease Surveillance
Environmental Health
Population Health/Epi
Other
Please describe why you are interested in working for Larimer county Health and Environment
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Please describe what skills and experience you hope to gain by working with Larimer County Health and Environment
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When would you be interested in starting?
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Month
-
Day
Year
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When would your end date be?
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-
Month
-
Day
Year
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How did you find out about this opportunity with Larimer County Health and Environment?
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Referred by staff
Referred by friend
Larimer County website
Other
Submit
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