SPECIAL REQUIREMENTS: Please include with your application a separate document with answers to all the following questions:
DSH-Napa- Recreation Therapy Internship Questionnaire
Please answer the following questions as fully and as concisely as possible so we may become better acquainted with you and your internship objectives.
Please print legibly, or type. If you choose to use a separate sheet, please include the question number prior to each answer.
Name: _____________________________________________
School: ____________________________________________
Is this a Bachelor or Master’s Level Program? ______________
Graduation Date: ___________
Are you planning on being CTRS or RTC? __________________
1. What is your reason for desiring an internship at DSH-Napa?
2. Tell about your field work experiences and how it has prepared you for an internship.
Please include the various focus populations you worked with and approximate number of hours outside direct classroom experience.
3. What facets of therapeutic recreation interest you the most? (modalities, populations, etc.)
4. What facets of therapeutic recreation interest you the least?
5. Discuss your areas of strength in recreation and group process:
6. Discuss your areas of weakness in recreation and group process:
7. Have you had any experience in planning large group activities? If so, please describe including target population and group focus.
8. Have you had any experience with individual therapy or case study? If so, please describe including target population and focus course of action.
9. Do you have any interests that you would like to incorporate into your profession as a Recreation Therapist?
10. Please name any activities or any recreation therapy process that you are not interested or comfortable with? What and Why?
11. Please write a concise “Statement of Purpose”. This should include your personal philosophy of what Therapeutic Recreation is, what you want to accomplish during your internship, and anything else you consider pertinent to this question.
Thank you for taking the time to complete this questionnaire.