Intern Application Form

Internship Inquiry.

Interested in becoming an intern at Mother & Child? Fill out some info and we will be in touch shortly. We are grateful for your interest in Mother & Child.

Name

First Name

Last Name

Phone

(###)

###

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

College & Instructor/Supervisor (if applicable):

Availability

Mother & Child's regular operating hours Mon-Thurs 10am-5pm, Fri-Sat 10am-3pm. Also let us know the duration of volunteer commitment

Specialty

Field of study, additional languages, certificates/licenses, etc.

Educational Goals and Objectives (if applicable):

Affiliations

Community Group, Service/Volunteer Organization, Church or School

Message

References (add up to 2 non-family references)

First Reference:

First Name

Last Name

Relation

Years Known

Phone

(###)

###

####

Second Reference:

First Name

Last Name

Relation

Years Known

Phone

(###)

###

####

Internship Inquiry.

Mother & Child Education Center1515 NE 41st AvenuePortland, OR 97232(503) 249-5801 (English)(503) 913-9360 (Spanish)

Mother & Child Education Center
1515 NE 41st Avenue
Portland, OR 97232
(503) 249-5801 (English)
(503) 913-9360 (Spanish)