Thank you for your interest in interning at the Lexington-Fayette County Health Department. For your convenience, please complete the Internship/Practicum Interest Form below. You will be contacted within two weeks of submission.

Today's Date (required)

Name (required)

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Academic Institution (required) Asbury UniversityEastern Kentucky UniversityNorthern Kentucky UniversitySullivan UniversityUniversity of KentuckyWestern Kentucky UniversityOther
[group other-academicinstitution]Please list institution name (required)[/group]

Degree In-Progress (required) AssociateBachelorMasterDoctoral (PhD)

Is an internship, service learning experience, observation or rotation required for your degree? (required) YesNo

Public Health Areas of Interest (required) AccreditationAdministrationClinic (Nursing)Community Health/Health EducationEnvironmental HealthEpidemiology/Communicable DiseaseHANDSPreparednessWorksite WellnessWIC/Dietetics

Internship/Practicum Semester (required) Fall (August-December)Spring (January-May)Summer (May-August)

Anticipated Start Date (required)

Anticipated End Date (required)

Total Internship/Practicum Hours Required (required)

Why are you interested in interning at the Lexington-Fayette County Health Department? (required)

Computer Skills (required):

Other Skills/Trainings/Abilities (required):

What are your professional objectives for this internship/practicum? (required)

Why are you a great candidate for this internship/practicum? (required)

What are your future career aspirations? (required)

Academic Advisor's Name (required)

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Please Attach Your Resume

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