Internship Interest Questionnaire
We are so excited to get to know you and to learn about your internship! Please complete this questionnaire so we can better know how we can assist you.
Email address *
Today's Date
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First & Last Name
Your answer
Residential Address (please include city & state)
Your answer
How did you learn about our organization?
What is your current education status?
Which college/university are currently attending or planning to attend?
Your answer
Is this school online or in person?
What is your degree program?
Your answer
How many credits is your program?
Your answer
If you are a MSW degree candidate, please check which track applies:
When is your expected graduation date?
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How many internships are needed for your program?
Your answer
Are you seeking placement for your general practicum or final clinical internship?
When is the anticipated start date(s) for your internship/practicum(s)?
Your answer
How many internship hours are required to complete your internship/practicum(s)?
Your answer
How long are you internship/practicum(s)? (i.e. 6 months)
Your answer
Are there any special requirements for your internship(s)?
Please expound on any special requirements noted above.
Your answer
Are you seeking regular employment?
If seeking employment, when are you available to start?
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What are your career goals after graduation?
Your answer
Are you 21 years of age or older?
Please send your resume to CareerTrack@lastingchangeinc.org.
Thank you for your interest in Lifeline Youth & Family Services! An Internship Administrator will review your responses to the questionnaire and respond within 7 - 10 business days.
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