PACIFIC CENTER for HUMAN GROWTH
Clinical Services Program
Internship Application 2006-2007
Applications are accepted for positions which start in September.
Applications should ideally be received by Pacific Center for Human Growth prior to mid-April, 2006. Pacific Center utilizes a rolling admission policy. The application process ends when all positions are filled.
Return this form, along with your most recent resume or curriculum vitae, two (2) letters of recommendation, and an official transcript to:
Pacific
Center for Human Growth
Saloma Clarence, Clinic
Administrator
2712 Telegraph Avenue
Berkeley, CA 94705
Section 1: Applicant Information
| Name: | Date of application: |
| Home address: | Email address: |
| Home phone: | Work phone: |
| School: | Graduation date: |
Section 2: References
Please list two (2) references with at least one from your most recent placement, if applicable. If you are from another country, list two (2) local references if possible.
| Name | Agency / Organization | Relationship | Phone |
| 1. | |||
| 2. |
Section 3: Tell us about yourself
Please answer the following questions. If you need more space you may include one additional page.
| 1. Why are you interested in training at the Pacific Center? |
| 2. What are your learning objectives for next year? |
| 3. What unique skills and talents would you bring to an internship at the Pacific Center? |
| 4. What personal and/or professional experience do you have with the lesbian, gay, bisexual, and/or transgender communities? |
| 5. Is there anything you would like us to know about your class and cultural background? |
| 6. What personal or professional work have you done with regards to diversity issues? How would this impact your work at Pacific Center? |