Internship Interest Form

Thank you for your interest in interning at the Jessamine County Health Department. For your convenience, please complete the Internship/Practicum Interest Form below. You will be contacted within two weeks of submission.

Contact our Administrative Specialist for any questions.

Today's Date

Subject Student Internship/Practicum

Your Academic Institution (required)

Degree In-Progress (required)

Is an internship, service learning experience, observation or rotation required for your degree? (required)

Public Health Areas of Interest (required)

Internship/Practicum Semester (required)

Anticipated Start Date (required)

Anticipated End Date (required)

Total Internship/Practicum Hours Required (required)

Please Attach your Resume

210 East Walnut Street Nicholasville, KY 40356