Internship Application

Thank you for your interest in an Iowa Department of Public Health (IDPH) internship. IDPH is committed to providing quality, practical internship experiences for students. However, the department receives many internship requests and is unable to place all applicants.

Most internships are unpaid. Students who complete an internship with IDPH are NOT guaranteed future employment at IDPH.

Note: Required fields are marked with an asterisk**

Contact Information

* First name:

* Last name:

* Email address:

Phone:

* Academic Institution:

* Area of study:

* What degree are you currently pursuing?:

If indicated "No degree at this time," what is the highest level of degree you have completed?:

Academic Credit

Check this box if you are applying for this internship with the intention of receiving academic credit.

If you checked the box for academic credit, the fields in this section are required.

* Faculty contact name:

* Faculty contact email:

Faculty contact phone:

Ext:

* Number of hours required to obtain academic credit:

Internship Request Details

* Preferred number of hours per week:

* Days available (select all that apply):

* Internship must start after this date:

format required: mm/dd/yyyy

* Internship must end before this date:

format required: mm/dd/yyyy

* What type of internship are you available for?:

Solely at IDPH Offices
Telework Only
Combination of IDPH Offices and Telework

Please note that IDPH offices are located in the Des Moines metro area

Current Opportunities

Check this box if you are applying for a specific current opportunity listed on the IDPH Internships website.

If you checked the box to apply for a specifc opportunity, the following two fields in this section are required.

* Select a current opportunity:

Note: if no drop-down options appear there are currently no specific opportunities available. If you are interested in more than one current opportunity, you must submit an application for each opportunity.

* I agree to the terms and responsibilities outlined in the details of the current opportunity selected.

Areas of Interest

If not applying for a specific opportunity, please complete the fields in this section.

* Describe the areas of public health that interest you:

* Describe the types of responsibilities you would like to be tasked with:

Additional Information

How did you hear about internships at IDPH?:

Additional comments:

Terms of Agreement

IDPH internship responsibilities:

To maintain a work schedule agreed upon with the preceptor

To complete the specified tasks of a project, including written assignments

To meet with the preceptor as needed to discuss project progress

To maintain contact with the faculty advisor regarding project progress as defined by the faculty advisor, if applicable

To complete any IDPH-required human resource forms, including a confidentiality statement

* Do you agree to the list of IDPH internship responsibilities?:

YesNo

* I understand that I am applying for an uppaid internship :