Education

Internship Requirements

Availability

Employment Questions

Authorization for Release of Information

I hereby authorize the release to WELLSPAN PHILHAVEN of any and all information relative to my internship, including but not limited to dates of employment, attendance records, performance ratings, rates of pay and eligibility for reemployment. I authorize its release without penalty or liability. A printed copy of this authorization shall be considered as valid as the original.

Personal Reference (No relatives or previous supervisors)

Professional Reference (No Relatives)

Authorization

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for internship as may be necessary in arriving at an internship decision. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any internship relationship with this organization is of an "at will" nature, which means that the intern may resign at any time and the organization may end the internship at any time with or without cause. It is further understood that this "at will" internship relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of the organization. In the event of internship, I understand that false or misleading information given in my application or interview(s) may result in ending the internship. I understand, also, that I am required to abide by all rules and regulations of the organization.

WellSpan Philhaven Application Supplement

Upload a copy of your resume above. You may also email your resume to Daryl Groff (dgroff3@wellspan.org).