JMSW Advanced Standing Specialist Internship Application
The application packet, including required documentation and attachments are to be submitted by the due date on the Advanced Standing Field Instruction Calendar.
Email address *
Today's date *
Semester/Year the internship is sought for: *
Your LAST Name: *
Your FIRST Name: *
Your Middle Initial:
NC A&T SU Student ID Number (starts with 9): *
UNCG Student ID Number (starts with 8): *
Mailing Address (street name, number, etc.) *
Home/Cell Phone: *
Work Phone:
Anticipated date of graduation: *
Enter as Month/Year, ex: 05/2019
Will you be employed this year? *
If you will be employed, which describes your employment type?
Have you ever been convicted of any criminal charges, including a felony? Note: most participants will need to be able to pass an agency-based background check. *
Do you have a valid N.C. driver's license? *
Will transportation be a problem for you? *
If transportation will be a problem, please explain:
Short Answer Section
You may wish to compose your answers offline and then paste them into the relevant text boxes, but you can type directly into the text box.
List the strengths you have which may contribute to a successful internship: *
List three skills, goals, or learning opportunities you would like to gain in your specialist internship: *
List three client populations, in order of preference, of interest to you for your specialist internship (if known): *
List three sites, in order of preference, of interest to you for your specialist internship (if known): *
Explain any issues that may impact your choice of possible internship sites. For example: Mental Health/Substance Abuse issues, no car or a suspended driver’s license, or received services from a campus based program (i.e., Office of Student Disabilities). These issues are to be discussed with the Co-Directors of Field Instruction prior to internship assignment. It is the responsibility of the student to apprise the Co-Directors of Field Instruction of this information: *
*Note: The Co-Directors of Field Education will take your learning skill goals, client population, and site preferences into consideration when locating potential placement sites, but cannot guarantee all preferences will be met in your placement. We will discuss your specific Specialist Year goals in more detail during your Field Interviews with us.*
Document Uploads
Please attach your professional resume following the chronological format of the template below. Include Educational Objective, Work Experience, Volunteer/Previous Internship Experience, Special Skills/Competencies (foreign language, sign language, training experience), etc. *
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Please upload proof of your valid driver’s license and automobile insurance (copy of declaration page and copy of driver’s license or state ID). *
You can upload these as either one file or two separate attachments.
A copy of your responses will be emailed to the address you provided.
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