Internships Internship Inquiry Name* First Last Chosen Name (If different than above) Chosen Pronouns School* PhoneEmail* What is the name of the degree you are pursuing? (e.g. Master's of XX)* At the time of your practicum/internship experience, how many years into your educational program will you be (e.g. 1st Year, 2nd Year, etc.)? Are you a Washington State Workforce Development Initiative (WDI) Recipient? Yes No What program(s) are you interested in? (Check all that apply)* Adult Outpatient* Adult Intensive Outpatient Child & Family Outpatient* Child & Family Intensive Outpatient Crisis Response & Stabilization Facility-based Programs Which counties are you available to intern? (Check all that apply)* Snohomish County Skagit County Island County San Juan County Whatcom County Are you looking for a practicum or internship placement?* Practicum Internship Other What is the total length of your school's practicum/internship?* What is the start date of your practicum/internship course?* Are there specific requirements for the type of internship supervisor your school requires? MHP LMHC LMFT LICSW Other None Do you have any special requirements for your placement? (For example: You must be able to do XX hours of family counseling)Do you have any special interests? (For example: Working with adult clients; working in non-traditional settings; etc.)Attach your resume* Drop files here or Select files Max. file size: 50 MB. Anything else you would like to let us know in determining a practicum/internship placement?CAPTCHA
