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Internship Application

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CRPHI Internship Application

Last Name
First Name
Current Mailing Address
Permanent Mailing Address
E-mail Address
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    County of Legal Residence
    Select University
    Major/Degree/Program
    Expected Graduation Date
    Preferred 6-Month Internship Time Frame
    Will you be completing the internship to meet program requirements (BS- internship course credit, MPH- Practicum)
    Please list the Health Science courses you will have successfully completed prior to the start of the internship.
    What days are you available to complete work for the internship?
    Monday 8a-12p
    Monday 12p-5p
    Tuesday 8a-12p
    Tuesday 12p-5p
    Wednesday 8a-12p
    Wednesday 12p-5p
    Thursday 8a-12p
    Thursday 12p-5p
    Friday 8a-12p
    Friday 12p-5p
    Weekend (rarely with events)
    Please check the languages you are fluent in both speaking and writing:
    English
    Spanish
    Somali 
    Other
    If other, please identify below:
    What makes you the best candidate for the internship? Please identify your skills, education and experience that sets you apart from others. Also include programs and software that you are experienced in working with, including, but not limited to: Canva, social media, SPSS, MS Office products: i.e. Word, PPT, Excel, etc. 
    Please upload examples of work you have done to demonstrate your skills (this may be considered your portfolio). Examples can include school work, communications products, data work, etc.
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    What are your career goals and how will this internship with CRPHI help you achieve them? 
    What types of skills or experiences would you like to achieve from your internship?
    CRPHI focuses on the eight Foundational Public Health Responsibilities for Local Public Health Departments. These are Assessment & Surveillance, Community Partnership Development, Equity,Organizational Competencies, Policy Development & Support, Accountability & PerformanceManagement, Emergency Preparedness & Response, and Communications. Please identify the responsibility area(s) you are most interested in working on and why.
    Please describe what you know about rural public health programs/services.
    Please identify the name of a MSU, Mankato Dept of Health Science Faculty member who can provide a reference for you:
    Please list the names, title, relationship to you and phone number and e-mail addresses for any additional professional references.  
    Signature:
    Clear
    Today's Date:

    CRPHI is a collaborative of 25 counties across South Central and Southwest Minnesota working

    together to address Public Health Foundational Public Health Responsibilities.

     

    This application and all information collected or disseminated on this individual regarding any

    internship will be maintained by Human Services of Faribault & Martin Counties for up to seven years.

     

    Human Services of Faribault & Martin Counties is an Affirmative Action/Equal Opportunity Employer

     

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