Is Home Care Right for You

Personal Information

Name

First Last

Email

Phone

Address*

Street Address Address Line 2 City State ZIP Code

Anticipated date of completion of AMTA coursework*

What is your primary instrument(s):*

Education Information

Name of College or University*

Director of Music Therapy Department*

Email

Phone

Address*

Street Address Address Line 2 City State ZIP Code

Musical Proficiency

Musical Instrument Proficiency*

List the instruments you play (voice, guitar, piano, etc.) with proficiency, include years of study and skill level (beginner, intermediate or advanced) for each.

Short Essay Questions

Answer the following questions in complete sentences and paragraphs.

1. Describe your experience with working in hospice and bereavement. (May include personal and practicum experience)

2. Describe your musical skills and background, including any skills you need to improve.

3. Describe your therapeutic skills, including any skills you need to improve.

4. Why did you choose the VNA as a possible internship site and what do you hope to gain from this internship?

5. Is there any additional information you would like to share that may be relevant to your application?

Additional Information

Upload a letter of eligibility and recommendation from your AMTA University Music Therapy Director

Max. file size: 100 MB.

Upload letters of recommendation from your practicum supervisor and personal/employment reference

Max. file size: 100 MB.

Upload current resume detailing all academic, professional, and relevant personal information

Max. file size: 100 MB.

Upload official transcripts from your university

Max. file size: 100 MB.

Include a link to an online video, e.g. Youtube of yourself playing 3 hospice appropriate songs and one song of your selection on your primary instrument

For your hospice repertoire, include 2 songs sung with guitar accompaniment and one sung with piano. Please describe why you chose the songs and how you would or have used them with a hospice patient. Along with the 3 songs, please include a brief summary about yourself and why you would like to work in hospice.

Agreement

All information supplied is complete, true and correct*

Yes, I agree

I understand that if selected for an internship position, I will be required to undergo a criminal background check, physical examination, TB Gold, and drug screening. I will be required to provide proof of liability insurance, driver’s license, and car insurance. Signing this application confirms that I am eligible for an AMTA National Roster Internship and that I have a valid driver’s license.

Email

This field is for validation purposes and should be left unchanged.

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Music Therapy Application

Personal Information

Education Information

Musical Proficiency

Short Essay Questions

Additional Information

Agreement