Human Services Leadership Home Academics Undergraduate Graduate Certificate Career Opportunities Resources Apply for a Scholarship Criminal Background Check Field Placement Information Field Experience Request HS-BCP Board Certified Practitioner HSL Program Request Form TK20 Login Faculty and Staff Contact Us Placement Partners Request Form Step 1 of 3 33% Date* MM slash DD slash YYYY Placement | Agency InformationAgency | Organization Name* Website Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneAgency Description (check all that apply) For Profit Non Profit [501 (c)(3) status] Non Profit [other] Government/Municipal Organization Other Primary Programing Area*Children and FamiliesEducation and TrainingSenior ServicesHealth and WellnessMeeting Basic NeedsCriminal JusticeDomestic/Sexual AbusePlease select the program area that best fits your agency or organization.Mission StatementType of clientele served by agency / organizationSummary of services offered by organization Internship Coordinator InformationContact First Last Title PhoneEmail Supervisor Requirement*YesNoThe HSL is accredited by the Council for Standards in Human Services Education (CSHSE). This accreditation requires internship supervisors to have a bachelors degree or above. Is your agency able to comply with the accreditation requirement. Internship InformationPlease select the type of field experience(s) that will be provided at your agency/organization* Internship (120 hours) Advanced Internship (280 hours) Semester Availability* Fall (September -December) Spring (January -June) Summer (June - August) What semester can students be placed at your agency or organization?Internship Hours Availability* Days Evenings Weekends Check all that applyMaximum number of students that can be placed each semester* Description of Duties - Internship (120 hours)*Please provide the type of work students will be assigned, activities and learning opportunities for each field experience the agency will offer. Description of Duties - Advanced Internship (280 hours)*Please provide the type of work students will be assigned, activities and learning opportunities for each field experience the agency will offer. Leadership Experience - Advanced Internship (280 hours)The advanced internship is required to have a leadership component to the experience. Please describe the opportunities for leadership experiences. BrochureMax. file size: 1 MB.If your organization has a brochure you would like to include in the directory listing please upload it here. Δ