First Name
*
Last Name
Email
*
Phone
*
What is your current cumulative GPA?
*
What year do you anticipate graduating?
What University are you attending?
*
Practicum/ Internship Year?
1st Year
2nd Year
Student Status
MSW Advanced Standing
MSW Concentration Year
MSW Foundation (1st year)
Psychiatric Nurse Practitioner Student
CPC or MFT Student
BSW Field Practicum 2
BSW Field Practicum 1
What motivated you to apply at Intentional Living Academy?
Please describe any previous relevant Coursework, Volunteer Work, Or Internships?
What specific skills or experiences do you hope to gain during your work with us?
What do you hope to contribute to our organization during your practicum placement?
Describe a project or accomplishment that you are particularly proud of and why.
Do you have any specific expectations or preferences regarding the type of work or projects you'll be involved in during your practicum?
Do you have any specific schedule needs (nontraditional hours evenings/ weekends, etc...)?
Do you currently have anything on your background that would disqualify you from obtaining a license to practice as a clinician.
Yes
No
I don't know.
Please explain if needed.
If there is anything else you would like us to know and consider about your application for a practicum position, please share here.
Please upload contact information (name, phone, email) for three references. At least 1 of the 3 needs to be a professional reference.
By providing my contact information, I agree to receive messages from ILA.
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