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HC DrugFree Internship Interest Survey

Thank you for your interest in an internship with HC DrugFree.  Please complete the registration below, and we will be in touch.  If you have any questions, please email admin@hcdrugfree.org. 

Joan Webb Scornaienchi, Executive Director and Rebecca Eng, Educational Coordinator

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* 1. First Name

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* 2. Last Name

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* 3. Preferred pronouns

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* 4. Email address

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* 5. Re-enter email address

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* 6. Best phone number to reach you?

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* 7. Alternative phone number (if none, re-enter phone number from above)

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* 8. What school do you attend?  If a college student, please list your school in the box below.

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* 9. Your Grade?

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* 10. We offer a variety of opportunities to help interns gain experience in areas of interest to them.  Which of the following would you be interested in participating in as an intern?  (Check all that apply.)

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* 11. Thank you for registering.  If you have any additional comments or questions, please include them here. 

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