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Communities In Schools- Internship Placement Application: Spring 2018
Please complete this form to give Communities In Schools a better understanding of your interests and background. Once this form is received your application will be reviewed and you may be contacted via email regarding a potential interview and campus placement. In addition, please send your resume to kwalker@ciscentraltexas.org.
Name:
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Date:
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Email Address:
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Telephone Number:
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University/College:
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Major:
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Degree (Undergraduate, Graduate, Doctorate, LPC-I)
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Number of total hours needed for the Internship:
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Date Internship hours needs to be completed by:
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In order to find an appropriate placement for you, please indicate any supervision or licensure requirements for Communities In Schools Staff overseeing your placement.
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*Please note that CIS Staff Members overseeing your internship placement will provide weekly supervision/check-ins for Interns. However, this does not count toward required clinical supervision hours for professional liscensure.
Check your grade level preference:
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Check all geographic location preferences:
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Check available days:
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What are your available times:
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*Please note that CIS Internship hours range between 7:30am - 4:30pm Monday - Friday, with very limited opportunity for evening hours
Required tasks and responsibilities for Internship (i.e. family hours, direct service hours, group hours, etc. )
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Briefly list an previous experience you've had working with youth.
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Comments:
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Please list your University Contact Information:
Name of Professor/Advisor:
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Email Address:
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Phone Number:
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Each Intern undergoes a criminal background check (national sex offender, state check, and national check) prior to beginning their internship on campus. Interns will not meet unsupervised with students until each of the background check results has been completed and both Interns and CIS Supervisors have been notified of clearance. Interns are subject to dismissal for disqualifying indicators on their criminal background checks.
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