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Request for Internship/Clinical Placement
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Student Information
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Internship/Clinic Information
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Student Information
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School Information
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Program of Study
Community Health
Nursing
WIC-Nutrition
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Degree
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RN to BSN
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Other Description
Instructor Name
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Instructor Email
Address1
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Internship/Clinic Information
Required Number of Hours
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Start Date
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Is there a project requirement? If so, please describe
Additional Comments
Also email a copy of the curriculum, student evaluation form/criteria and resume to PHE@co.washington.mn.us
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