Asian Health Services REACH Internship

Note

All fields marked with * are required and must be filled.

Personal Information

Name *

First

Last

Permanent Address *

Street Address 1

Street Address 2

City

State / Province / Region

Zip / Postal Code

Country

Current Address (if different from above)

Street Address 1

Street Address 2

City

State / Province / Region

Zip / Postal Code

Country

Email *

Phone Number *

High School *

City/State *

GPA *

College *

City/State *

GPA *

Area of Study *

Date of Graduation or Expected Graduation *

Graduate School (only if applicable)

Area of Study

Place of Birth *

Years in U.S. *

List languages; indicate level of reading, writing, and speaking fluency *

Family Information

Father's Name

Title

First

Last

Suffix

Father's Occupation

Father's Place of Birth

Father's Highest Level of Education Completed

Father's Number of Years in U.S.

Mother's Name

Title

First

Last

Suffix

Mother's Occupation

Mother's Place of Birth

Mother's Highest Level of Education Completed

Mother's Number of Years in U.S.

Personal Statement (read directions below) *

Please write, in 1000 words or less, a statement in which you describe why you want to be considered for REACH and how your past community experiences will make you an invaluable REACH intern. It is recommended you write your statement in a word processing program (i.e. Microsoft Word, Wordpad, etc.), save, then copy and paste the statement into the box. This will prevent any frustration should any errors occur.

Goals (read directions below) *

Please describe, in 1000 words or less, your career goals and explain how REACH can help you develop the type of skills you will need to achieve those goals. It is recommended you write your statement in a word processing program (i.e. Microsoft Word, Wordpad, etc.), save, then copy and paste the statement in here. This will prevent any frustration should any errors occur.

Online Signature

By typing in my name below, I acknowledge that participation in the entirety of the program is expected and required of all REACH interns. In the event my application is selected, I will accept the offer only if I am able to participate in the full eight weeks of the program. It is recommended you write your statement in a word processing program (i.e. Microsoft Word, Wordpad, etc.), save, then copy and paste the statement in here. This way, should there be any mishaps occur when submitting, you will have a backup.

Type Your name *

Date *

YYYY

Note

If you press submit and nothing happens, please go through your application again, as there are likely errors with the answers you may have given, or you may have missed a required field. Errors are marked by the field turning a pink color.

If you are still unable to submit, please contact Dr. Nghe Yang: drnyang@gmail.com