Bloomington Internship Application

School Attending

Year in School

Major

Internship Interest*

Within the description of the General Resettlement internship program, you'll see different areas in which you may be assisting staff. In the list below, please rank your interest in each area, from Most Interested to Least Interested.

Dependent on an intern's availability, we do our best to focus their work in the service areas that are of greatest interest to them.

Areas of Interest (drag options to rank from Greatest Interest to Least Interest):

Available Start Date*

Date

Estimated End Date*

Date

Describe the academic requirements for your internship:

For academic purposes, do you require weekly supervision meetings with an Exodus staff member?*

YesNo

If yes, how many hours per week?*

Does the supervising staff member have to have a specific degree or certification (e.g., MSW or LCSW)?*

YesNo

If yes, what specific reporting requirements will be asked of the supervising staff member? Will a site visit by a professor or academic advisor be required?*

Are you able to commit to at least 16 hours (office hours) per week for at least 10 weeks? (Please note: we ask that interns allow for a minimum of four hours per shift.)*

YesNo

Weekly Availability for Internship: Please specify the times that you are available to work at Exodus. (Note: Each checkbox indicates that you are available for that hour. For example, if you select the "4 p.m." checkbox, this indicates that you are available from 4-5 p.m.)*

	N/A	9 a.m.	10 a.m.	11 a.m.	12 p.m.	1 p.m.	2 p.m.	3 p.m.	4 p.m.
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY

	Yes	Some	No
Office Work
Teaching/Tutoring
Advocacy
Graphic Design
Fundraising
Photography

Bloomington Internship Application

Academic Information & Availability

Skills & Experience

Needed Documentation