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Intern Request Form

Is your organization interested in hosting a student?

Thank you for thinking of our students! Please complete the Intern Request Form below. After submitting the form, someone from the Office of Public Health Practice will contact you to follow up on the opportunity. Or, you can email us at OPHP@uab.edu and we will be happy to work with you to create a position description (or post one you already have developed) and recruit student(s) for your position.

We look forward to working with you to place a UAB School of Public Health student at your organization and creating a meaningful and informative practice experience while supporting your organization’s overall goals and objectives.

Intern Request Form

Organization/Agency Information

Organization Name

Organization Type Organization Type

Brief Description of Organization (ex. Mission, Goals, Values)

Point-of-Contact

Point-of-Contact Phone

Point-of-Contact Email

Description of Project

Scope of Practice Experience (description of project student will be involved in)

Anticipated Responsibilities of Student Intern

Does this project require IRB approval?

Yes

No

Desired Student Qualifications/Attributes

Desired Qualifications of Student Intern

Desired Education Level of Student Intern (select all who the applied practice experience will be open to)

Public Health Undergraduate Students

Public Health Graduate Students

Public Health Doctoral (DrPH) Students

Please indicate if there is a specific area of public health in which the student should have knowledge/background for your internship.

All areas of public health may apply

Biostatistics

Environmental Health Sciences

Epidemiology

Global Health

Health Behavior

Health Care Organization

Health Policy

Industrial Hygiene

Maternal and Child Health

Occupational Health and Safety

Has a potential students been identified for this position?

No

Yes (potential student name and email)Yes (potential student name and email)

Position Details

Semester of Performance (select all that apply)

Spring

Summer

Fall

Number of Positions Available

Expected work schedule for student

Not very flexible, the intern MUST be at work on certain days of the week and at certain times of the day

Flexible, the intern can largely set his or her own hours

Is a salary or stipend available?

Salary or Stipend Available

Unpaid

Please specify amount of salary or stipend.

How should students apply?

Required Documents for Student Application

Resume

Cover Letter

Transcript

OtherOther

How should the student apply?

Email point-of-contact listed above

Email another individual in my organization

Through an open posting (please include link to where the position is posted)Through an open posting (please include link to where the position is posted)

Please include the name, title, and email of the person in your organization to whom students should apply,.

Additional Information

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Still have questions? Please reach out to the Office of Public Health Practice with any questions, comments, or to request additional information.

Email ophp@uab.edu

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