Fillable Prospective Internship Site Profile (University of Florida)

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Prospective Internship Site Profile (University of Florida)

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Prospective Internship Site Profile
Department of Health Education & Behavior
Location: ______________________________________________________ Date: __________________
City State
Agency: __________________________________________________________________________________
Contact: __________________________________________________________________________________
Address: __________________________________________________________________________________
Street / PO Box City State / Zip
Phone: ___________________________________ Fax: _____________________________________
Email: ___________________________________ Website: _________________________________
What semesters is your agency available to accept interns?
Fall (August – December) Spring (January – April) Summer (May – August)
Normal work hours (Please indicate any evening or weekend time commitments):
Is office space available to interns? Yes No ______________________________
Comments
Is a computer available to interns? Yes No ______________________________
Comments
Does your agency offer paid or non-paid internships? Non-paid Paid (amount): ___________
List other benefits your agency offers interns (i.e. housing, health insurance, travel reimbursement, etc.)
List required purchases for interning with your agency (i.e. parking pass, uniform, etc.)
Gainesville
Fl.
0217/2016
Center for Independent Living of North-central Fl. (CILNCF)
Tony Delisle
222 SW Terrace
Gainesville
Fl / 32605
352-378-7474
http://cilncf.org/
✔
✔
✔
Mainly Monday through Friday from 8:30-5:00. Some weekends and / or evenings are required.
✔
✔
✔
May also want lap tops
We cover the costs ($80) for conducting the Level 2 Background screenings we require for interns. Travel
reimbursement may be covered based on the activity being conducted.
None
List the required skills or previous experience necessary for interning with your agency.
Special Requirements (i.e. special application, proof of health insurance, immunization, etc.)
Please note: All interns are required to purchase professional liability coverage for $1,000,000.
List a description of duties your agency expects to be fulfilled by interns. Please include additional literature if
desired.
List any important information about your agency.
Would you like to be added to the Department’s list of approved sites for future interns? Yes No
FOR OFFICE USE ONLY: CONTRACT ON FILE: ________________________________________
Approval of Intern Coordinator: _____________________________________ Date: ___________________
Approval Expiration Date: _________________________________________
Skills include: being highly motivated and self directed: having the ability to work well with other;
demonstrate effective problem solving skills: ability to effectively communicate with a diverse array of
people; having a good working knowledge of health education and behavior; ability to adopt to challenges;
demonstrate satisfactory professional etiquette (maintaining confidentiality, being punctual, respectful
communication, dress appropriately, etc.)
Complete required CILNCF paperwork (volunteer form), and complete a level 2 background screening.
The activities interns can expect to complete may include but are not limited to: planning, implementing,
and evaluating health promotion programs; creating and delivering health education lesson plans for our
Independent Living Program; conduct life skills workshops for our High School High Tech program;
participate in community outreach, networking, and capacity building efforts; help to run our advocacy and
peer support groups; assist in conducting needs assessments and evaluations of program outcomes.
✔
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Prospective Internship Site Profile (University of Florida)

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Completed 11 October 2021

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