GO Internship Application

  • Garland Oaks Internship Application

    Important Notice: You must be 21 years or older to intern at Garland Oaks.
  • Format: (000) 000-0000.
  • What is your available start date?*
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  • What days of the week are you available to work?*

  • Internship Information

  • Do you have experience working with youth?*
  • Do you have any experience working with victims of trauma?*

  • References

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  • Conduct + Competency

  • It is the purpose of Street Hope/Garland Oaks to ensure a safe, sound and secure environment for the residents in order to aid their health and healing.  As part of our licensure process with various entities (Department of Children’s Services, etc.), we are required to ensure soundness of staff and other related individuals (e.g., interns, etc.) who will interact professionally with the residents. Please answer completely the following questions related to conduct and competency. 

  • Have you ever been expelled, terminated, reprimanded for or disciplined by an employer or educational institution for misconduct including (1) dishonesty/fraud/deceit, (2) lying or misrepresentation on a resume or academic application, (3) academic misconduct (including cheating or plagiarism), (4) theft/destruction of property, and/or (5) sexual harassment/misconduct?*
  • Have you ever been denied a social work, counseling, psychotherapy, counseling-related or other allied health-related license or renewal in any state?*
  • Have you ever been denied the right to take a social work, counseling, psychotherapy, counseling-related, or other allied health-related licensure examination?*
  • Have you ever had a license to practice any profession revoked, suspended, sanctioned or otherwise disciplined and/or had to participate in a disciplinary proceeding/administrative action in any state?*
  • Is there any current or pending or do you anticipate any complaint against your professional conduct or competency in any state or jurisdiction in any social work, counseling, psychotherapy, counseling-related, or other allied health-related profession?*
  • Do you currently have any condition or impairment (may include but not limited to substance abuse/misuse, alcohol abuse/misuse, mental condition, and/or medical condition) which currently affects your ability to practice and/or your ability to deliver essential services related to your course of study/major/concentration for this internship?*
  • Is there any other information you would like to share?*
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  • Date*
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