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Internship/Student Research Interest Form
Contact Information
First Name
Last Name
Email Address
Academic Institution
Degree Program (e.g., BS, MPH, PhD)
Current Year in School (e.g., Junior, Senior, Graduate)
Internship/Research Request Details
Which of the following are you interested in:
Internship
Research Assistantship (GRA/RA)
Practicum experience
Course credit
Experiential learning credit
Public health honors
Other
Preferred term of internship/research
Fall
Spring
Summer
Other
Availability (days/times):
Payment required? (Funding dependent upon project)
Yes
No
Area(s) of Interest:
Research
Outreach
Communications
Public Policy
Injury Topic Interests:
Falls
Bullying
Occupational injuries
Roadway Safety
Workplace violence
Trauma
Bicyclist and Pedestrian Safety
Domestic violence
Sports injuries
Prescription opioid overdose
Youth violence
Other:
Rural safety
Child abuse
Communications (social media, data visualizations, etc.)
Please indicate your current research and software skills:
Survey creation
Participant interviews
Survey administration
Manuscript preparation
Data management
Writing for general audiences (e.g., brochures, handouts, etc.)
Software programs, e.g., Excel, SAS, R, Access, Endnote, GIS, Tableau, etc. (please list)
Scientific presentation (oral or poster)
IRB applications
Social media (list which platforms):
Participant consent
Infographics
Literature search
Other (please list any other skills relevant to research):
What are your top 2-3 goals for an injury research experience?
Project Description-- Describe the type of project you would like to work on and/or the type of skills you would like to gain or improve upon.
Please attach a current copy of your CV or resume.
Drop files or click here to upload
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