CIIP Intern Request Form

APPLICATION PROCESS

Interested partners must first submit a Community Partner General Application before submitting the form below. The deadline for submitting the CIIP Intern Request Form is March 1, 2020.

Thank you for your interest in the Community Impact Internships Program! As we select interns, we will also be reviewing CIIP Intern Request Forms during the months of February through March. In addition to submitting the CIIP Intern Request Form below, community partners are required to submit a Community Partner General Application which will help identify additional partnership opportunities and resources. Learn more and submit a partner application today.

Before you begin the form, be aware of the following:

  1. There are multiple short answer questions (see below). Unfortunately, once you begin your CIIP Intern Request Form, you do not have the ability to “save” it. We strongly encourage you to write your short answers in advance so you can easily “cut and paste” them into the form below.
  2. If your organization participates in CIIP, you may be asked to sign a Community Partnership Agreement with the Center for Social Concern which will provide a clear outline of our partnership and expectations for CIIP.

To learn more about becoming a Community Partner of the Center, please contact our Community Partnership Specialist, Nairuti Shastry.

Community Impact Internships Program Intern Request Form

Community Impact Internships Program Intern Request Form

Contact Information

Address where intern would primarily be located
City
State/Province
Zip/Postal

Additional Information

The Center for Social Concern can pay for this expense. However, you must provide the CSC with the organization's CJIS authorization number to ensure the results are sent directly to the organization. The CSC will not receive or retain a copy of the intern's results.
You must provide the CSC with the organization's CJIS authorization number to ensure the results are sent directly to the organization. The CSC will not receive or retain a copy of the intern's results.
Maximum upload size: 2.1MB
Maximum upload size: 2.1MB
Has your organization submitted the CSC's Community Partner General Application?*
Please check as appropriate.*
Sending