2024 Internship/Counselor Application

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Below is an application to get training and clinical experience working with kids with anxiety disorders and Selective Mutism. You will have an opportunity to be paired with a child and help them meet their therapeutic goals. All interns will be background checked before the start of the program.

2024 Camp Dates

Session 1: July 29 - Aug 2

Session 2: Aug 5 - Aug 9

First Name *

Last Name *

Email Address *

Phone Number *

Please indicate your current occupation or current school status (ie. college student, grad school, social worker, etc) *

Please list any relevant experience working with children. *

Please list any relevant experience working in the mental health field. *

Are you hoping to get supervised clinical hours as part of a training program? *

Yes

If you are in school, what school or training program are you currently enrolled in? *

Will you be available to work in Patchogue, NY from July 29th - August 9th?

Yes

Why do you want to be a part of the summer camp program? *

Please list 2 references who can speak to your work ethic and/or character.

**You will be notified before someone contacts references.

How did you hear about this program opportunity? *

Submit

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