University of West Florida
Health Education Program
Prospective Internship Site Profile
1. Location: _______________________________ Date Completed: _____________________
City State
2. Agency: __________________________________________________________________________
3. Agency mission/purpose: ____________________________________________________________
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4. Agency website (if applies): __________________________________________________________
5. Contact: __________________________________________________________________________
6. Address: _______________________________________________________
Street/P.O. Box Suite#
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City State Zip
7. Phone: (______) _______-_____________ 8. Email Address: ___________________________
9. ___Non-Paid ___Paid (amount) $_______________
10. Other benefits (i.e. housing, health insurance, travel reimbursement, etc.):______________________
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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): ____________
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___Very Flexible ___Somewhat Flexible ___Non-Flexible
Pensacola, FL
10/10/2006
Escambia County Health Department
To protect the public's health by partnering with the community
to prevent disease, promote wellness, and prepare for disaster.
www.escambiahealth.com
Ildi Hosman
1295 West Fairfield Drive
850
595
6272
ildiko_hosman@doh.state.fl.us
17. Required purchases (i.e. parking passes, uniform, etc.): ___________________________________
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18. Required skills or previous experience needed: ___________________________________________
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19. Description of intern duties (please include additional literature if desired): ____________________
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20. Other important information about internship: __________________________________________
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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
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none
Public speaking and excellent communication
skills
Community
presentations, event planning and execution, research and data analysis and trending.
NA