Prospective Clinical Intern Questionnaire:
Name
1. What is the name of your school and program of study?
2. What are the total number of hours needed to complete?
3. What would be your expected start date?

MonthDayYear
Date
a. Expected completion date?

MonthDayYear
Date
4. On average, how many hours do you intend to commit per week?
5. Our hours of clinical operation are M Th 9am 7:30pm and Friday 8am 12pm. What is your general availability?
6. The Virtue Center's main office is in Norman with a satellite office in Purcell (approx 30-minute drive) Would you consider Purcell as a primary location? (A) Interested in interning primarily at the Purcell location Only (B) interested in interning at the Norman location (C) Interested in interning primarily at Norman location, but open to some hours in Purcell Open to either?
7. Please rank your populations of interest 1-3, with number 1 being your first choice.
Criminal Justice
Adolescents (12 17yo)
General
8.Do you have a supervisor preference?
Email
example@example.com
Phone Number
Please enter a valid phone number.
Should be Empty:

Internship Form

*All intern openings are currently filled until May of 2024