University of South Florida – College of Public Health
Florida Public Health Training Center (FPHTC)
Funded Field Placement Opportunity
Funded by the U.S. Department of Health and Human Services
Health Resources and Services Administration (HRSA)
Instructions:
All fields are required.
Please email a copy of your RESUME to:
Beth Ann Bourquardez
(Training Support Specailist),
ebourqua@health.usf.edu
Application Deadline:
November 13, 2012
Awardee Notification:
November 26, 2012
The following are required of a HRSA Field Placement Intern:
All field placements are three (3) credit hours and require that the student intern commit a minimum of 135 hours over the course of the Spring or Summer 2013 semester.
Familiarity with the Association of Schools of Public Health Core Competencies for MPH students and incorporation of as many interdisciplinary and discipline-specific competencies as possible into the field experience.
Successful completion of the mid-semester and final reports.
Successful completion of HRSA demographic profile and supplemental evaluation.
Student intern should have completed the required hours by the last day of classes of the semester.
Commitment to adhere to USF College of Public Health Field Placement Program requirements and professional code of ethics.
Name:
Current Mailing Address:
City
State
Zip
Permanent Mailing Address:
City
State
Zip
Home Phone:
Cell Phone:
Personal E-mail Address:
School E-mail Address:
Department/Concentration of Study:
Completed Credit Hours:
Expected Date of Graduation:
Do you have a reliable mode of transportation?
Yes
No
Available days of the week and times for field placement:
Days:
Times:
1. Explain why you are interested in a field experience in a medically underserved area. (250 words minimum)
2. Describe any past/current work experience that has prepared you for an experience in a medically underserved area.
3. Describe the knowledge and skills you hope to gain as a result of your participation in this field experience. (250 words minimum)
4. Upon completion of your graduate studies, would you be inclined to work in a setting that has been identified as a medically underserved area? Please explain. (250 words minimum)
You may be contacted for an interview for this field experience. What days of the week and times are you available for a short meeting?
Day(s):
Morning
Afternoon
Before submitting, please print a copy of this application for your records.
