Virtual Practicum Student Application - ALL SECTIONS ARE REQUIRED
APPLICATIONS ARE NOW OPEN FOR SUMMER 2022
SUMMER COHORT DATES ARE 5/16-8/5 
THE DUE DATE FOR APPLICATION SUBMISSION IS JANUARY 3, 2022
(the application for our Fall Cohort will open following the Summer Cohort deadline)

    Personal Information

    Documents
    ​(ALL DOCUMENTS MUST BE SUBMITTED IN PDF FORMAT TO BE ACCEPTED)

    Max file size: 20MB
    Max file size: 20MB
    Max file size: 20MB
    Max file size: 20MB

    ​Two Letters of Recommendation are required for your application to be considered.
    Please have your references email your recommendation letters to info@childlifeunited.org with your name in the subject line.

    We will also allow you (as the applicant) to submit the recommendation letters if you have them in your possession from previous applications
    (please email to info@childlifeunited.org with your name in the subject line). 

    Emergency Information

    Languages

    other languages and degree of skill (Learning, Basic, Fluent) 

    Academic Information

    Use the space below to state the highest level of education (in process or completed).

    ​EXPERIENCE WITH CHILDREN, YOUTH OR FAMILIES 
    Healthcare Setting

    ​Please list all healthcare experiences (volunteer, practicum student). If additional space is needed use comment box.

    Experience with Children, youth or families
    Stressful situations

    ​Please list all stressful situation experiences (camps for children with chronic illness, programs for children with special needs, advocacy programs, bereavement/ hospice). 

    Experience with Children, youth or families
    Well Child

    ​Please list all well child experiences (nanny, counselor, teacher).
    ​

    Additional Work Experience

    Essay Questions

    Financial Assistance

    ​If you choose yes to this question, please copy and paste the following link into another tab on your browser. Please ensure to submit the current practicum application prior to moving onto the google form which is our needs based scholarship application. *Note- the scholarship application is also due on 1/3
    https://forms.gle/njiSTjQmxgh2SAbh7