Public Health Internship and Volunteer Application

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Application Category
Contact Information
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: 000-000-0000.
Mailing Address

Street Address

Street Address Line 2

CityState

ZIP Code
Why are you interested in Wake County Public Health?

0/1500
Are you related to any current employee of the department?
What is your preferred choice? (Applicants under the age of 18 may not work in clinical areas, the labs or the pharmacy.)
If your preferred choice is unavailable, what would be your second choice? (Applicants under the age of 18 may not work in clinical areas, the labs or the pharmacy.)
Are you fluent in any languages (in addition to English)? If so, which language(s)?
What objectives do you hope to achieve during this experience?

0/2000
Please attach your resume here.

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Are you seeking academic credit?
Please attach your university credit verification.

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Please attach your course/credit requirements or internship syllabus.

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School Name
Enter your school's name
Semester
Degree & Major
Anticipated Graduation Date
Required number of internship hours
Preferred Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Preferred End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Weekly availability and requested number of hours
Project assignment needs

0/800
What are the expectations of the preceptor during the internship?

0/800
Education level
Additional Comments
How did you hear about this internship opportunity?”

Other (please specify)
Please verify that you are human
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