Internship Application

Name

Email

Age

Phone Number

Do you accept text messages on your phone?

Yes

No

Address

Internship Type

Community Health

Healthcare Administration

Semester/Graduating Year and Month

Semester Hours Needed to Graduate

Start Date

End Date

Why are you interested in the internship?

Goals for the internship

Past Volunteering Experiences

Thank You for Applying! You will receive a followup email after your application is reviewed.

Our mission is to share the love of Jesus Christ to our neighbors in Champaign County by providing holistic, free, and quality health care services.

PO BOX 5005, Champaign, IL 61825

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