Freedom Psychotherapy & Wellness Services, PLLC Internship Application
Intern
First and Last Name *
Phone Number *
Address *
Pronouns *
How did you hear about this opportunity *
University currently attending or graduated from *
Major, minor, and/or concentration *
(Expected) graduation year *
GPA *
Is this internship needed for school credit *
Please indicate your daily schedule availability with total of 10 hours per week *
When can you start if granted this opportunity *
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What if anything could get in the way of you completing this minimum 10 hour a week, 6-month commitment to this internship? *
List 3 References: Name, title, company, phone number, email address *
May we contact these references *
Please describe your online marketing experience. *
Please describe your previous work/volunteer experience. *
What have you enjoyed most about previous intern/volunteer/work positions? *
How much time could you allocate towards internship? *
What skills and qualifications do you have that will help you in this position? *
How would you describe your flexibility/adaptibility? *
What type of rewards do you need to stay motivated (i.e. words of affirmation, public praise, private acknowledgment, etc.)? *
Please share a lifetime professional goal and a lifetime personal goal *
What kind of people do you most enjoy working with? Additionally, how do you feel about working with people different from yourself? (i.e. differentracial/ethnic backgrounds, developmentally disabled, different socio-economic,backgrounds, different sexual orientation, etc.) *
How do you manage conflict and what is your previous experience with diffusing the situation? *
How do you handle a situation when you know that you are unable to complete an assignment or commitment? *
Among the following skills and interests what will aid your during your internship at Freedom, please choose the top 5 what most align with your person. *
Required
Among the following, please choose the top 5 values that most align with yours. *
Required
If for X reason you are unable to complete your 6 month commitment to the Freedom Internship Program, which of the following options would you choose to proceed with? *
Describe how others would view you as a role model. *
A book that changed your life? *
Rightie or Leftie? *
There is a short stack of 3 pancakes. Which pancake would you be and why? *
You application is not complete until you email your resume and 1-2 minute video on why you are a perfect candidate for this program to NadieLPC@FreedomPsychotherapy.net *
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