First and Last Name * Preferred Name * Current Address Permanent Address * Preferred Email Address * Preferred Phone Number * Name of Emergency Contact * Emergency Contact Phone Number * Emergency Contact Relationship to You * What languages other than English do you speak? * Are you applying for academic credit for this internship? * If yes, who is your supervisor? Please include contact information. * Please list 1 of 2 professional references that we may contact. * First Reference's Relationship to You * First Reference's Email Address * Please list a second professional reference that we may contact. * Second Reference's Relationship to You * Second Reference's Email Address * What school do you currently attend? * What is your major field of study? * What particular skills, talents or gifts do you have that you would like to use in your placement at SMA? * When would you like an internship placement? (check all that apply) * Summer 2025 Fall 2026 Spring 2026 What are your anticipated start and end dates? * Where would you like to intern? (check up to 3 preferences) * Administration Case Management Facilitation/Education Development/Fundraising Editorial Media/Web design Community Outreach Public Relations Social Work Youth Prevention Other If you are human, leave this field blank. Submit