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YMCA Adaptive Recreation Internship / Fieldwork Hours Request Form
Thank you for considering us, please read below.
We offer Internships and fieldwork opportunities every semester of the year.
We are an unpaid internship site that requires at least one weekend day of the week.
1.
Please fill out below.
First and Last Name
Cell Phone
Email Address
2.
School Information
Name of your School
Professor's Name
Professor's Email Address
3.
Which degree are you currently pursuing?
Associates
Bachelors
Masters
Doctorates
Other (please specify)
4.
Describe this internship / fieldwork hours please.
School Requirement to Graduate
Community Service Hours / Experience
5.
Have you interned or volunteered with Adaptive Recreation before?
Yes
No
6.
Please select your area of study below.
Recreational Therapy / Rehab
Occupational Therapy
Physical Therapy
Pre-Dental / Pre- Med
Exercise Science
I am not sure
Other (please specify)
7.
Please answer as best as you can.
Approximately how many hours a week would you be with us?
8.
Approximate Internship
Starting Date?
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
9.
Approximate Internship
Ending Date?
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
10.
In a few sentences, why do you want to choose us for an internship?
