Application for Child & Youth Field Experience

Application Deadline

Fall Placement - February 15th

Spring Placement - September 15th

Please fill out this form to apply for an internship. After completing this short form, you will be able to download the full internship form.

Semester you are
applying for:
First Name:
Last Name:
Address:
City/State/Zip: ,  
E-mail Address:
Home Phone: ( ) -
Birth Date: ,
UIN:
Block:
Major:
   
County: