Internship Application

Please fill out the form below to apply for our internship program.  Select “Outreach and Education” for the area of interest if you’re applying for the Outreach Internship, select “Research” if you’re applying for the Patient Engagement Internship, and select “Technology/Clinical Informatics” if you’re applying for the Data Analyst/Build Internship.  Please also specify which internship you are applying for in your letter of interest.

Note: All uploaded files must be doc,pdf,txt,gif,jpg,jpeg,or png with a maximum file size of 1mb. The system will not allow you to upload a docx file.

Comments or questions are welcome.

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First Name

Last Name:

Email:*

Phone Number:

Address:

City:

State:

ZIP:

Where did you find out about the internship program?

What is your area(s) of interest? Select all that apply.

Technology/Clinical Informatics
HIT Implementation
Research
Education/Outreach

Which internship position are you applying for?

What is the length of program that you are interested in

3 months
6 months

Date you are available to start an internship:

CHITREC internships are conducted during regular business hours (Mon - Fri, 9am - 5pm) at the CHITREC office or partner organization’s office Approximately how many hours per week are you available to work during this time frame?

Letter of Interest: Please Limit to 2 pages and emphasize relevant coursework or previous positions*

Acceptable file types: doc,docx,pdf,txt,gif,jpg,jpeg,png.
Maximum file size: 1mb.

Resume*

References: List 3 professional references, including name, title, organization, and contact information*

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