Center for Clinical Excellence - Training Institute Application
What Is Your Name?
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First Name
Last Name
What Is Your Phone Number?
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-
Area Code
Phone Number
What Is Your Email?
*
example@example.com
What Internship Are You Applying For?
*
Please Select
Mental Health - Clinical Intern
Case Management Intern
Behavioral Health - Tiny Home Villages
Which University Do You Attend?
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What is Your Program/Degree?
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How Many Internship Hours Does Your Program Require?
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These are defined as total practicum hours.
How Many Weekly Internship Hours Would You Like to Commit at THS?
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When Is Your Expected Start Date?
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When Is Your Expected End Date?
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What are Your Current Degrees and Licensures?
How Did You Hear About Our Program?
University
Word of Mouth
THS Website
Other
Please Upload Your Resume Here
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