Allied Health Internship Program ApplicationStep 1 of 520%Program EligibilityWill you be 18 years or older by May 1, 2025?* Yes NoDo you reside in Los Angeles county?* Yes NoDo you meet the required areas of study for the program?* Yes NoApplicants must be in at least one of the areas of study: Medical Assistant, Licensed Vocational Nurse, Behavioral Tech, Pharmacy Tech, Health Information Technology, Billing and Coding, Dental Assistant, Dental Hygienist, Phlebotomist, Community Health Worker, Promotor/a, Substance Abuse Counselor, Patient Care Representative/Patient Navigator/Care Coordinator, Administrative – Customer Service, Reception, Call Center, etc., and/or Undergraduate majors – Community Health, Health Education, Social Work, Health Administration.This program requires you to participate in all of our virtual workshops and complete 110 in-person clinical hours are a health center during the following timeframe: May 15, 2025 - July 31, 2025. Are you able to commit to the program timeframe?* Yes NoNote: Program Graduation Ceremony is in-person and scheduled on August 7, 2025 from 5:00pm - 7:00pm.Will you be graduating from your program/college by August 1, 2025 or have already graduated from your program/college?* Yes NoThank you for your interest! Based on your responses to the first five questions, you are not eligible for the program.Unfortunately, you are not eligible for the Allied Health Internship Program this year. However, I advise you to check-out our job board, submit your resume on our resume bank, and subscribe to our job board newsletter where you will be able to receive career opportunities. If you have any questions or concerns regarding your eligibility, contact recruitment@ccalac.org. Thanks!Demographic QuestionsName* First Last Email Address* Enter Email Confirm Email Cell Phone Number*Date of Birth* MM slash DD slash YYYY Current Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country How many miles from your address are you willing to commute to your placement site? Check all that apply.* 1 - 5 miles 5 - 10 miles 10 - 20 miles 20 miles and aboveNote - This information helps us with the matching process. While we can't guarantee placement at the health center closest to you, we will do our best to match you with a site that meets both your preferences and the needs of the health center.Gender: How do you identify?* Male Female Transgender Male Transgender Female Non- Binary Please write your pronouns below.*What is your race/ethnicity? Check all that apply.* Asian/ Pacific Islander Black/ African American White/ Caucasian Native American/ Indigenous Hispanic/ Latino OtherDo you speak and/or write any languages other than English?* Yes NoPlease indicate each language and proficiency:Example: Spanish - Basic, Proficient, or Fluent How did you hear about our program?*Area of StudyWhat area of study did you complete or are you currently in? Check all that apply.*Note - If you are unsure if your major/area of study will be accepted, please e-mail recruitment@ccalac.org Medical Assistant Licensed Vocational Nurse Substance Abuse Counselor Community Health Worker Behavioral Tech Patient Care Representative/Patient Navigator/Care Coordinator Promotor/a Pharmacy Tech Health Information Technology Billing and Coding Dental Assistant Dental Hygienist Phlebotomist Administrative – Customer Service, Reception, Call Center, etc. Undergraduate majors – Community Health, Health Education, Social Work, Health AdministrationIn what school did you complete or plan to complete the program in?* Please write the full name of the school. If you completed multiple programs in different schools please list them all in respect to the allied health profession. For example: Los Angeles Trade Technical College - Phlebotomy program; West Los Angeles College - Medical Assistant Program; etc.Date Degree/Certification/License Earned or Expected*Note - You must be graduating by August 1, 2025 to be eligible for the program.Will you be having any other commitments during the program timeframe (May 15, 2025 - July 31, 2025)? If so, please specify the type of commitments you have below.*Note: Program Graduation Ceremony is in-person and scheduled on August 7, 2025 from 5:00pm - 7:00pm.Internships are scheduled to begin on June 1, 2025 and hours are completed between Monday - Friday between 8am - 5pm. Is there anything we should know about your availability?*Personal Insight QuestionsWhy do you want to work in community health?*Please write a meaningful and thoughtful response. Limited to 4500 Characters, including spaces.Tell us about your experience working with diverse populations in a community setting.*Please write a meaningful and thoughtful response. Limited to 4500 Characters, including spaces.Resume & Unofficial Transcript Document UploadAt the end of this application you have need to upload your most up-to-date resume as well as your unofficial transcripts for enrollment verification purposes. Please ensure that resume is updated and accurately reflect your education, internships/fellowships, part-time/full-time work experience, extracurricular activities and any volunteer experiences. Thanks!Upload Your Resume*Accepted file types: pdf, Max. file size: 16 MB.Please submit your resume as a PDF document.Upload your unofficial transcript for enrollment verification purposes.*Max. file size: 16 MB.Please submit your unofficial transcript of the program you are currently enrolled or completed as a PDF document.Interns receive $1,500 stipend for completing the 110-hour requirement.* By checking this box, you acknowledge that all program requirements must be completed to qualify for the stipend. You also understand that the stipend will be processed and distributed after the graduation ceremony on August 7, 2025, and this process may take 4 to 6 weeks.Signature*By signing this application, I affirm and certify that all the information and answers to questions here in are complete, true and correct to the best of my knowledge and belief. I understand that any misrepresentation, falsification, or omission of any facts called for in the application may render this application void.
