Fillable American-Heart-Association - Internship Profile UWF revised2

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American-Heart-Association - Internship Profile UWF revised2

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University of West Florida
Health Education Program
Prospective Internship Site Profile
1. Location: _______________________________ Date Completed: _____________________
City State
2. Agency: __________________________________________________________________________
3. Agency mission/purpose: ____________________________________________________________
___________________________________________________________________________________
4. Agency website (if applies): __________________________________________________________
5. Contact: __________________________________________________________________________
6. Address: _______________________________________________________
Street/P.O. Box Suite#
______________________________________________________
City State Zip
7. Phone: (______) _______-_____________ 8. Email Address: ______________________________
9. ___Non-Paid ___Paid (amount) $_______________
10. Other benefits (i.e. housing, health insurance, travel reimbursement, etc.):______________________
____________________________________________________________________________________
____________________________________________________________________________________
11. What type of interns does your agency seek? ___Part-time ___Full-time ___Both
12. What semesters is your agency available to accept intern placements?
___Fall (August to December) ___Spring (January to April) ___Summer (May to August)
13. Please indicate the last semester in which a UWF Health Education intern was placed with your
organization (if applies):_____________________________
14. Office space available to intern? ___Yes ___No
15. Computer available to intern? ___Yes ___No
16. Normal working hours (please indicate any evening or weekend time commitments): ____________
____________________________________________________________________________________
____________________________________________________________________________________
___Very Flexible ___Somewhat Flexible ___Non-Flexible
Pensacola, FL
11/06/06
American Heart Association
Our mission is to reduce disability and death from
cardiovascular disease and stroke.
www.americanheart.org
Natalie Padgett, Nikki Morrette
4400 Bayou Blvd. Ste #49-a
850
473
0411
natalie.padgett@heart.org
✔
NA; Skills and experience; 15-20 hours per week
✔
✔
✔
NA
✔
✔
✔
Office
open 8:30-5:00pm, we can work with school/work schedule, very few evenings/weekend
commitments
17. Required purchases (i.e. parking passes, uniform, etc.): ___________________________________
____________________________________________________________________________________
____________________________________________________________________________________
18. Required skills or previous experience needed: ___________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
19. Description of intern duties (please include additional literature if desired): ____________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
20. Other important information about internship: __________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Please return to:
Melissa M. Howard, PhD, MPH, CHES
Assistant Professor, Health Education
Department of Health, Leisure and Exercise Science
11000 University Parkway
Pensacola, FL 32514
Phone: (850) 473-7110 Fax: (850) 474-2106
Department Comments
To be completed by Health Education Internship Coordinator
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
NA
Computer skills and phone etiquette. Detailed
and organized, professional and punctual.
Daily
office operations such as phones, copies, supplies, etc. Speciall events- Heart Walk, Heart
Ball: recruiting personal affiliate organizations to participate, fundraising, work with staff,
volunteer time to actual kickoffs and day of event needs, shadowing staff on appointments,
secure in-kind donations for walk event, soliciting for auctions items for the ball event.
(attached)
NA
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American-Heart-Association - Internship Profile UWF revised2

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Completed 18 November 2019

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