Internship

Healing Hearts Music Therapy

Personal

* Indicates required field

Name *

First

Last

Email *

Address *

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City

State

Zip Code

Country

Phone Number *

Current University: *

Current year in School *

Junior Senior Graduate/equivelency

Desired Start Year *

When would you like to start internship *

Spring Fall Summer Any

Start times are based on the academic year and last for 6mos

Vocal Proficiency *

Please indicate your level of proficiency for the following:

Guitar Proficiency *

Piano Proficiency *

Please list any additional instruments on which you are proficient: *

What populations have you worked with? *

Individuals Groups Infants Toddlers/Preschoolers Children/School aged Adolescents/Teens Adults Older Adults

Check all practicum experiences that apply: *

Preschool Special Education General Hospital NICU/PICU Health & Rehab Mental/Behavioral Health Older Adult/Assisted Living Hospice Other

Please list any additional practicum or work experiences not included in the list above *

Why do you want to intern with Healing Hearts Music Therapy? *

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