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St. John's Hospital | Children's Hospital | Child Life Specialists

Child Life Student Intern Application

Please complete, required fields *

Name

Email address

Address

City State Zip

Daytime phone

Year in School Semester Applying for Internship

College Attending
Major/Minor
Graduation Date (mm/dd/yyyy)

Name of Child Life or Related Studies Professor

Phone Number of Child Life or Related Studies Professor

List Related Course Work (Provide at least 5)

Please explain how you became interested in Child Life:

Describe the role of a Child Life Specialist within the hospital setting:

List 5 goals/expectations you have for this internship experience:

What qualities do you have that would be a good asset to the Child Life Program
at St. John's Hospital:

Other information you would like to share about yourself: