The Center for Health Improvement Internship Application

Have Questions? Please contact Kelly:

kflaska@kumc.edu
Phone: 785-623-5296

Internship Deadlines:

Spring Term – October 1
Summer Term – March 1
Fall Term – June 1

    Your Name (required)

    Your Email (required)

    Your Phone Number (required)

    Address

    Date of Birth (MM/DD/YYYY)

    Applying for Internship during following semester

    Credit Hours Needed

    Emergency Contact Name & Number

    College(s) Attended

    Hometown

    Degree Seeking or Obtained
    Degree SeekingObtained Degree

    Emphasis

    Date Graduated or Expected Completion Date (MM/DD/YYYY)

    Nickname

    Applicable Certifications (ACSM, NASM, CSCS, etc)

    Goals (Personal & Professional)

    Interests

    Shirt Size
    SMLXLXXL