Clackamas County Public Health Internship Application Thank you for your interest in furthering your educational experience with Clackamas County Public Health. This application collects your: Contact Information Academic Information Academic Requirements Public Health Interests References (one academic, one professional or work-related) Resume or CV Requirements Good academic standing with university/training program. An active contract between your organization and Clackamas County Public Health. If a contract is not currently in place, this will delay any potential placement. Pass a pre-placement Criminal Background Check. We may need the following based on placement. Drug Screening Documentation of current immunizations Documentation of Bloodborne Pathogens Training Additional Information Placements are offered on a case-by-case basis dependent upon staff availability and organizational capacity. Completing an application does not guarantee placement. All internships positions are unpaid. Please direct all inquires to PH-Internship@clackamas.us Question Title * Contact Information Full Name Street Address City State Zip Code Phone Email Languages spoken - Level of proficiency Question Title * Academic Information Undergraduate BA Undergraduate BS Registered Dietician Nursing - ADN Nursing - BSN Nursing - MSN Master of Public Health (MPH) Master of Social Work Other Master's LCSW PhD DrPH Other Question Title * What is your area of focus or concentration? (if necessary) Question Title * School and Advisor information School Name Academic Advisor Advisor Email Advisor Phone Preferred Start Date Question Title * Are you seeking credit for this intership? Yes No Not sure Question Title * Briefly describe your academic requirements Question Title * Briefly describe the areas of Public Health that are of interest to you (example: data and epidemiology, chronic disease prevention, encivonmental health, etc.) Question Title * Please describe your relevant work, lived, or academic experience Question Title * Please share what you hope to gain from an internship Question Title * Reference 1 (academic) Name Title Organization Address Phone Email Question Title * Reference 2 (professional or work-related) Name Title Organization Address Phone Email Question Title * Upload Resume or CV (pdf only) PDF file types only. Choose File Choose File No file chosen Remove File Upload Resume or CV (pdf only) Done