Request edit access
Native Health Initiative-Internships
Loving Service: the human-to-human element of wanting to serve others.
Email address *
Select the Internship you are applying for:
Any questions - please email shannon@lovingservice.us or call 505-340-5656
PART I: CONTACT INFORMATION
Name (First and Last Name): *
Your answer
Age: *
Your answer
What best describes you? *
Phone Number: *
Your answer
Mailing Address: *
Your answer
School/Major/Career: *
Your answer
What is your Ethnicity/n/Nationality?
Your answer
PART II: Community Experience
1. Describe at least 2-3 experiences you have had while working/volunteering in the efforts to improve the health of a community. (Provide your role in the efforts, specific projects you worked on, and what you learned from these experiences).
Your answer
PART III: Talents, Skills ,and Knowledge
1. How comfortable do you feel working with others (and are you a team player)?
Your answer
2. What skills or talents do you have to offer NHI? (i.e. CPR, First Aid, Grant Writing, Poetry, Music, Dance, etc and these do not have to pertain to health)
Your answer
PART IV: Addressing inequities in health through Loving Service.....
1. How do you share love with the world and people around you on a daily basis?
Your answer
2. When you hear "loving service" what do you feel/think?
Your answer
3. How would you define "health justice?
Your answer
4. What do you think of the notion that health inequities can be address through loving service?
Your answer
5. What do you think are the biggest injustices/inequities in the U.S. healthcare system?
Your answer
If you are only applying for IHLI and/or Internship, SKIP to PART VI: Fun Questions
PART V: Logistics while serving others this summer....
1. This year 2020, our main internship sites are in New Mexico...Any additional things we should know?
Your answer
2. During the 5 week summer internship (choose one):
3. Additional things we should know about you.. what are your eating restrictions (gluten-free,vegetarian,)? What are your allergies? Do you have any medical conditions we should be aware of?
Your answer
4. Will you have a vehicle this summer? (note: does not affect whether you are accepted or not, but will help NHI determine placement.)
PART VI: FUN QUESTIONS (the most important part of the application):
1. If a woodchuck could chuck all of the wood they could chuck, what is the most likely diagnosis and why?
Your answer
Thank you for your submission!
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy