Center for Community Counseling BA Internship Application
CCC is proud to offer a robust internship coupled with ample training and supervision. Each year we host 2-4 Bachelor-level interns dedicated to serving a diverse array of mental health needs. *We require a minimum of 2 terms for all BA students.
Please fill out the questions below to be added to our interest list.
Legal Name
*
First Name
Last Name
Name (if different from above)
Pronouns (optional)
Phone Number
*
Email
*
example@example.com
Are you able to be physically in the office at least one day a week (M-F) during your internship?
Yes
No
Do you have any prior experience volunteering/working in the mental health field?
Yes
No
Please tell us about your experience:
Anticipated Start and End date.
If you are not sure of the exact dates, put the 1st day of the month your internship will begin or end.
Anticipated Start Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Anticipated End Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
University you are attending. If your university is not listed, you will be required to update your program's supervision/site requirements to be considered as part of the application process.
*
Universtiy of Oregon
Bushnell University
Other
What program are you in?
Psychology
Health and Human Services
Other
If your school is not listed, above, please provide a copy of your school's requirements regarding site responsibilities and supervision/supervisor requirements.
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Have you applied for a space in your schools's internship program yet?
Yes
No
Please attach your resumé and cover letter below:
Cover Letter
*
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Please submit a letter of interest or cover letter in a Word or PDF format
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Resumé
*
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Please submit a resumé in a Word or PDF format
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References
Please provide the name and email address of two references.
Name of Professional Reference
First Name
Last Name
Email of Professional Reference
example@example.com
Name of Academic Reference
First Name
Last Name
Email of academic reference
example@example.com
If we have any questions about your program's requirements, who should we contact?
Name
Email
Submit
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