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Internship Application

The mission of Affirmations is to provide a welcoming space where people of all sexual orientations, gender identities & expressions, and cultures can find support and unconditional acceptance, and where they can learn, grow, socialize and feel safe. We accept Intern Applications from both undergraduate and graduate students.


First Name
Last Name

First Name
Last Name
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These are the pronouns you prefer that other people use when referring to you. For example, if you use she/her/hers pronouns, we would say "She applied to be a counseling intern"
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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This is the date you would like to begin your internship.
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This is the date when you would like to end your internship.
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Please provide a copy of your State ID or Driver's License. Uploading an image of State ID/Driver’s License grants consent to Affirmations’ to perform Background Check.

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Please detail your goals and work that you wish to achieve during your internship in a one-page summary.
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Example: Please describe your experience with one-on-one therapy and/or group support if you are applying for Counseling.
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The LGBTQ+ Community is a diverse and intersecting group of folks. Please describe your understanding and interactions with the Community.

First Name
Last Name
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I grant permission to Affirmations or its assigns, to use in print, electronic, video, or audio format my name, voice, image or likeness of my minor child or myself. I, on behalf of myself, my child and our heirs and assigns, release Affirmations and its assigns from any liability or claim arising in any way from any use of said name, audio, image, or likeness, including but not limited to claims with respect to copyright ownership and publication, express or implied inaccuracies, disclosures, innuendo, or any claim for compensation related to the use of said audio, image, or likeness.