Intern Application

Contact Info

Name:

Address:

Phone:

Email:

Availability

Availability Start Date

Availability End Date

Hours per Week

Number of Weeks

Total Hours: 0

Please describe your work availability and explain significant schedule concerns

Interests

Please Drag 1 to 6 area(s) of the Department of Public Health in which you would like to work.
Place them in the order of importance to you:

Skills

Please rate your required skills in the following Public Health Core Compentencies
1 - Novice 2 - Between Novice and Competent 3 - Competent 4 - Between Competent and Expert 5 - Expert

Communication

Community Engagement

Data Collection and Analysis

Evaluation

Graphic Design

Marketing

Needs Assessment

No Preference

Organization

Policy Informatics

Program Design & Development

Public Speaking

Quality Improvement

Research

Spanish Speaking

Technical Writing

Web Design

OTHER

Questions

Why do you wish to volunteer or intern for the Maricopa County Department of Public Health?

What are your professional and personal objectives for this assignment?

What are your future career goals?

Education

School Credit

Yes. I am applying for this internship with the intention of receiving University or College Credit.

Academic Level

School Information

School

Degree

Focus

Start

End

(leave blank if still enrolled)

Graduated?

GPA

Additional School Information

School

Degree

Focus

Start

End

(leave blank if still enrolled)

Graduated?

GPA

Files

If you have files you wish to attach to your application, you may upload up to three (3) files here.
Click 'Browse' and select the file(s) to upload.

File 1:

File 2:

File 3:

Confirm and Submit

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Electronic Signature

Date

3/24/2023