Climate-Ready TCHR Internship Interests and Goals

Please complete this brief survey to help us find internship opportunities that address your interests and help you meet your goals.

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1. Your Name

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2. Email Address

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3. Please tell us what type of organization you want to do an internship with. Select all that apply in order of preference from 1 to 6. (Required.)

	1	2	3	4	5	6
Tribal community health center	Tribal community health center 1	Tribal community health center 2	Tribal community health center 3	Tribal community health center 4	Tribal community health center 5	Tribal community health center 6
Non-tribal community health center	Non-tribal community health center 1	Non-tribal community health center 2	Non-tribal community health center 3	Non-tribal community health center 4	Non-tribal community health center 5	Non-tribal community health center 6
Public health agency	Public health agency 1	Public health agency 2	Public health agency 3	Public health agency 4	Public health agency 5	Public health agency 6
Emergency preparedness and response agency or department	Emergency preparedness and response agency or department 1	Emergency preparedness and response agency or department 2	Emergency preparedness and response agency or department 3	Emergency preparedness and response agency or department 4	Emergency preparedness and response agency or department 5	Emergency preparedness and response agency or department 6
Social services organization (housing, food, education, etc.)	Social services organization (housing, food, education, etc.) 1	Social services organization (housing, food, education, etc.) 2	Social services organization (housing, food, education, etc.) 3	Social services organization (housing, food, education, etc.) 4	Social services organization (housing, food, education, etc.) 5	Social services organization (housing, food, education, etc.) 6
Community resilience center	Community resilience center 1	Community resilience center 2	Community resilience center 3	Community resilience center 4	Community resilience center 5	Community resilience center 6

Other (please specify)

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4. What do you hope to learn during your internship? (Required.)

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5. What kind of programs, services, or activities do you hope to observe and participate in during your internship? Please check all that apply. (Required.)

Community outreach

Health fair or other community event

Health education

Health screening

Connecting people with resources

Educating the community about emergencies

Emergency preparation or response planning and activities

Planning, facilitating, or participating in collaborative meetings or coalitions

Other (please specify)

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6. What skills do you want to learn or practice during your internship? Please select all that apply. (Required.)

Communication skills

Interpersonal and relationship building skills

Service coordination and navigation

Advocacy skills

Teaching and education skills

Capacity building skills (helping people or groups advocate for themselves)

Cultural responsiveness

Outreach and engagement skills

Assessment and data skills

Basic clinical and support skills

Evaluation skills

Other (please specify)

Climate-Ready TCHR Internship Interests and Goals

Question Title

* 1. Your Name

Question Title

* 2. Email Address

Question Title

* 3. Please tell us what type of organization you want to do an internship with. Select all that apply in order of preference from 1 to 6. (Required.)

Question Title

* 4. What do you hope to learn during your internship? (Required.)

Question Title

* 5. What kind of programs, services, or activities do you hope to observe and participate in during your internship? Please check all that apply. (Required.)

Question Title

* 6. What skills do you want to learn or practice during your internship? Please select all that apply. (Required.)

Question Title

* 7. What else do you want us to know that would help us find an internship that would meet your educational and professional goals? (Required.)

1. Your Name

2. Email Address

3. Please tell us what type of organization you want to do an internship with. Select all that apply in order of preference from 1 to 6. (Required.)

4. What do you hope to learn during your internship? (Required.)

5. What kind of programs, services, or activities do you hope to observe and participate in during your internship? Please check all that apply. (Required.)

6. What skills do you want to learn or practice during your internship? Please select all that apply. (Required.)

7. What else do you want us to know that would help us find an internship that would meet your educational and professional goals? (Required.)