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Internship Application

Master-level graduate students, thank you for considering Kayenta as a site for your student practicum internship. To learn more about Kayenta, please click here. For more about our Legacy Program, please click here.

Internship

Name *

Requested Internship Season *

Contact Phone *

Email Address *

University Name *

Program of Study *

Type of Internship *

Graduation Date (Month and Year) *

Are you currently doing an internship or practicum at another site? *

Yes

If yes, what is the other site? *

Have you completed a practicum or internship at another site?

Yes

If yes, what was the other site? *

How did you hear about Kayenta’s Legacy Program? *

Starting Date *

Kayenta is based on a private practice model, giving students time in an office. What days can you commit to seeing clients at Kayenta? *

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Are you able to schedule clients for mornings/evenings on your office days? *

Yes

What led you into the field of counseling? *

What are you looking for in a counseling internship? *

What theories do you enjoy using the most (EFT, Parts, EMDR, Gestalt, CBT, etc.)? *

Other information that you believe would be helpful (languages, special interests, etc.) *

Are you interested in working with a specific group demographic (i.e. children, LGTBQ) or have anything you would prefer NOT to see in your practice? *

What are your plans for the future? *

If you are human, leave this field blank.

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