Internship Application
Internship Application For Embracing Abilities Inc.
What internship are you applying for?
*
Recreational Therapy
Name
*
First Name
Middle Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
Confirmation Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you legally eligible for employment in the U.S?
*
Please Select
Yes
No
Highest Level of Education
*
Please Select
High School Graduate
Associates Degree
Bachelors Degree
Graduate Degree
High School Attended
*
College Attended
Degree Received
Do you have a valid drivers license?
*
Please Select
Yes
No
Have you been convicted of a misdemeanor or felony in the last 5 years?
*
Please Select
Yes
No
How did you hear about Embracing Abilities?
*
What are your short and long-term professional goals?
*
List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc).
*
Do you have experience working with children or adults with special health care needs? If so please describe.
*
Please check any current specialized training and/or certifications you have received that are applicable.
*
CPR/AED
First Aid
CNA
LPN
RN
RBT
Crisis Intervention
Positive Behavioral Supports
Please list 3 references below. Please list name, phone, email and relationship. *Please provide references that are not related to you. If contact information is not listed your application will not be processed.*
NAME, PHONE, EMAIL and RELATIONSHIP is REQUIRED for all references.
I understand the following items are required for an internship with Embracing Abilities and interns are responsible for all fees involved with obtaining or maintaining the requirements. CPR/AED/FIRST AID- Negative Tuberculosis Screening- State Limited/Local Background Checks.
Type Your Full Name (First, Middle, Last)
By electronically signing this application for internship, I certify that I have read and understand all parts of the application, and I certify that the information provided by me in this internship application are true, correct, and complete to the best of my knowledge. I certify that this application was completed by me. If an internship is offered and accepted, any misstatement or omission of fact on this application may result in termination, regardless of when falsification may be discovered. I understand that additional information may be required in the process of applying for internship.
*
Type Your Full Name (First, Middle, Last)
Submit
Should be Empty: