Department of Rehabilitation - Internship Application Question Title * 1. Student Name Question Title * 2. University: Graduate Program San Diego State University California State University, Los Angeles California State University, San Bernardino California State University, Fresno San Francisco State University California State University, Sacramento Other Graduate Program menu Other (please specify) Question Title * 3. Best Email Address To Reach You: Question Title * 4. Best Phone Number To Reach You: Question Title * 5. Please state the type of placement that interests you. Practicum Placement (8 hours/week = 80 hours) Internship (40 hours/week = 600 hours) Question Title * 6. Please indicate the county in which you would like to be considered for placement. County Alameda Alpine Amador Butte Calaveras Colusa Contra Costa Del Norte El Dorado Fresno Glenn Humboldt Imperial Inyo Kern Kings Lake Lassen Los Angeles Madera Marin Mariposa Mendocino Merced Modoc Mono Monterey Napa Nevada Orange Placer Plumas Riverside Sacramento San Benito San Bernardino San Diego San Francisco San Joaquin San Luis Obispo San Mateo Santa Barbara Santa Clara Santa Cruz Shasta Sierra Siskiyou Solano Sonoma Stanislaus Sutter Tehama Trinity Tulare Tuolumne Ventura Yolo Yuba County menu Additional Counties (please specify) Question Title * 7. Do you have an interest in working as a rehabilitation counselor for the Department of Rehabilitation in the future? Why or why not? Done