Core Recovery

Intern Application

First Name *

Last Name *

Your College/University *

Your Program/Degree *

Internship Date - Beginning *

Desired Internship Start Date

Internship Date - End *

Desired Internship End Date

Internship Hour Requirements *

Please include the total internship hours you need and, if applicable, break them into direct and indirect. Please also list any hours requirements pertaining to supervision.

Availability *

During the date range you provided, please list days and hours you are available and also any times in which you are not available.

Phone *

Email *

Your Resume *

Please upload your resume and any supporting materials here.

Additional Information

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