Ensuring Health Care Access for Everyone

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Internship Application Date Received:
Personal Information

Name:

Address:

Cell Number:

Email:

Emergency Contact Name:

Emergency Contact Phone Number: Your Relation to this Contact:

Position Information and Qualifications

Please indicate the position for which you are applying:
CNA/MA/Nurse Nutrition Dev. Coordinator Pura Vida Intern Child Care Coordinator
Child Care Intern Evaluation Intern Social Media Intern Clinic Coordinator Intern
EHR Intern Diabetes Coordinator Diabetes Intern Other (Please specify)
For descriptions on any of these positions, please visit our website at http://healthfindersmn.org/getinvolved/

CNA/MA/Nurse candidates: submit copies of current license/certificate and relevant credentials,
including proof BLS.

College: Carleton St. Olaf Other Grade Year:

Languages Spoken: SpanishSomaliEnglishOther (please specify)

Supporting Documents

Please submit with this application:
1. Cover Letter
0ffei of Employment - Page 2 of 2
a. Discuss relevant experiences, especially with low income and/or minority populations, or
cultures different from your own.
b. Why do you wish to volunteer with HealthFinders Collaborative?
2. CV/Resume or summary of work experience
a. Include a list of relevant experiences
b. Any skills/specialty/major
c. Two references with contact information
3. Background check document (Applicable to only CNAs and child care interns).
a. All CNAs/MAs/Nurse and child care interns are required to have a background check. If you do not
have a current one, go to (http://healthfindersmn.org/getinvolved/). Questions? Contact an HFC
staff at 507-649-0613.

Recruitment Information

How did you hear about these internship opportunities?
HealthFinders Collaborative Webpage
Posting (recruitment) on College Campus
referral from previous HFC intern.
Other. Please specify.

Signature: Date:

Print Name:
By signing, I affirm all information given herein, and in all associated attachment represents the
truth.

Please submit application to:

Charlie Mandile, Executive Director; mandile.charlie@healthfindersmn.org or mail application to our

Mailing Address:
HealthFinders Collaborative
P.O. Box 731
Northfield, MN 55057

Northfield Office Address: Faribault Office:
710 South Division St 223 Central Ave
Northfield, MN 55057 Faribault, MN 55021
Phone: 507-646-8964 Phone: 507-323-8100


Questions? Visit our website at http://healthfindersmn.org/getinvolved/