Internship application
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| Name
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| Address
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| Street Address
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| Address Line 2
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| Date of Birth
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Emergency Contact Information
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| Prefix
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| Relationship to you:
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General information
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| Do you speak/write any languages besides English? If so, what languages?
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| Are you currently employed?
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Yes No
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| If employed, where?
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| Are you a student?
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Yes No Recent Graduate
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| If yes, what school?
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| Will this internship be for school credit?
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Yes No
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| If yes, how many hours would you need to complete each week?
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0-10 Hours 10-20 Hours 20-30 Hours 30-40 Hours
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| Contact name & number of your professor/supervisor:
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| Estimaged start date
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| Estimated end date
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| Have you ever been convicted of a felony?
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| If yes, list convictions:
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| What do you want to focus your internship on?
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General (Focus on HIV testing and counseling, outreach presentations, client transportation, office assistance, other projects per need and intern interest) Marketing (Graphic design, web development, social media) Fundraising and grant writing Other
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Knowledge and Comfort
On a scale of 1-10 (1=very low, 10= very high) how would you rate yourself on the following?
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| My knowledge of HIV/AIDS
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| My comfort level in regard to gay, lesbian, bisexual and transgender issues
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| My comfort level in regards to topics of sexuality, safer sex, and sexual practices.
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| My comfort level in regards to drugs and people who use drugs.
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| My comfort level in regards to people who are living with HIV/AIDS or at risk for contracting HIV/AIDS.
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References
Please provide at least one character reference that is NOT a family member.
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| 2. Name
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| Please tell us about why you would like to complete an internship with Northern Colorado AIDS Project
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Thank you for filling out this application!
After your application is reviewed, you will be contacted to come in for an interview. You will then need to complete the intern training prior to starting your internship.
NCAP does not discriminate on the basis of age, race, ethnicity, national orgin, religion, ability, HIV status, gender identity, or sexual orientation.
Questions? Call the Intern Coordinator at (970) 484-4469 x18 or check out ncaids.org
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Image Verification
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EMF Online Survey
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