Internship Application Application for BCB IBCLC Internship Step 1 of 5 20% Overview The Bayou City Breastfeeding internship program was developed to help aspiring IBCLCs obtain the necessary clinical hours and skills to become an International Board Certified Lactation Consultant. Our program is specifically geared towards helping Pathway 3 candidates achieve the necessary clinical hours to meet the exam requirementsm. Our internship program is targeted towards candidates who want to work in private practice, and upon completion of the program, plan to join the Bayou City Breastfeeding team as a Lactation Consultant. The contract does include a non-compete clause. Length of Program We expect most candidates in the program will take 12-24 months to complete the program, but length of time will be dependent upon availability of the candidate and Bayou City Breastfeeding’s IBCLCs. Costs Enrollment fee: There is an enrollment fee due upon acceptance to the program. This enrollment fee is used to offset some of the costs for the intern to access our systems. Observational and Clinical Hours: Pathway 3 interns pay a fee (per hour) for all observational and clinical hours. Note that this may be different for a pathway 2 candidate that has completed their required clinical hours Our Pathway 3 Internship Program is an unpaid program. Interns are not paid for time spent accruing observational or clinical hours. Pathway 3 Interns are elligable to complete project-based work for pay as a 1099 contractor to help offset the cost of internship. Location Interns in our program will be expected to observe and work with multiple IBCLCs in all our locations across the Greater Houston Area. In addition, interns will be attending home visits throughout the Greater Houston Area and or San Antonio Area. Interns are responsible for their own transportation to/from the Bayou City Breastfeeding offices and to/from client’s homes. Applicant InformationName(Required) First Last Email(Required) Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone(Required)Best way to contact youEmailPhoneCertifications, Credentials and Licenses: (Please include date received and expiration date if applicable)Relevant Work History (Only need to list lactation, birth, or nursing related jobs):ResumeMax. file size: 100 MB. EducationDo you have a college degree? Yes No College or UniversityField of StudyType of DegreeYear EarnedRequired Health Science Classes All applicants must have completed all of the required health science classes PRIOR to starting their internship with Bayou City Breastfeeding. For each of the following items, please list what class you took to meet the educational requirement, where you took it, what grade you received (if applicable) and the completion date. Biology(Required)Human Anatomy(Required)Human Physiology(Required)Infant Growth and Child Development(Required)Introduction to Clinical Research(Required)Nutrition(Required)Psychology/Counseling/Communication(Required)Sociology/Cultural Sensitivity/Cultural Anthropology(Required)Basic Life Support(Required)Medical Documentation(Required)Medical Terminology(Required)Occupational Safety and Security for Health Professionals(Required)Professional Ethics for Health Professionals(Required)Universal Safety Precautions and Infection Control(Required)Lactation Specific Education In addition to the required Health Science classes, all candidates must have completed the required 95 hours of Lactation Specific Education. Please list the specific lactation education classes you have taken, along with who provided the class, the date completed and number of L-Cerps earned in the box below. Lactation Specific Education(Required) General Application QuestionsWhich IBCLC Pathway are you planning to use?(Required)Pathway 1Pathway 2Pathway 3Have you earned clinical hours towards the IBCLC prior to this program?(Required) No Yes Clinical Hours: Please indicate how many clinical hours you have already earned, and where you obtained these hours. Please also provide contact information for the person or mentor who supervised these hours.Do you plan to work outside of the internship during the program? No Yes Undecided Outside work: Please provide information on your employment plans during the program.What hours/days will you be available for the program?(Required)Do you have a target exam date? If so, when are you planning to apply for the IBCLC exam?(Required) Additional InformationWhy do you want to be an IBCLC?Where do you want to work after completing the IBCLC certification? (examples, private practice, hospital, physician’s office, research, teaching, etc.)Describe any experience you have assisting/counseling breastfeeding parents:What areas of Lactation are you especially interested in? Why?Why are you a good candidate for our Internship Program? ReferencesWe require 3 references. Please provide their name, contact information, position, what the person's relationship is to you and how long they have known you.Reference 1Reference 2Reference 3Consent(Required) I agree to the privacy policy.Consent and Terms & Conditions By submitting this internship application, I acknowledge and agree to the following: Accuracy of Information I certify that all the information provided in this application and any accompanying documentation is true, accurate, and complete to the best of my knowledge. I understand that any falsification, omission, or misrepresentation may result in the rejection of my application or, if admitted to the intership program, immediate termination of my internship. Consent to Background Checks I authorize Bayou City Breastfeeding LLC to verify all information provided in this application, including but not limited to education, employment history, professional certifications, and references. I also consent to background checks, which may include criminal history, if required. No guarantee I understand that completing this application does not guarantee acceptance into the BCB internship program Confidentiality of Information I acknowledge that any proprietary information provided by Bayou City Breastfeeding LLC during the application process is confidential and must not be shared or disclosed without explicit authorization. Use of Data I consent to the collection, processing, and storage of my personal information for the purposes of recruitment, employment decisions, and compliance with legal obligations. I understand that Bayou City Breastfeeding LLC will handle my personal data in accordance with applicable data protection laws and will not share my information without my consent, except as required by law. Acknowledgment of Policies If selected for the internship program, I agree to abide by the company’s policies, procedures, and standards of conduct, including those outlined in the Employee Handbook and other official communications. Electronic Submission I understand that submitting this application electronically serves as my consent to the above terms and my electronic signature. By checking the box below and submitting this application, I acknowledge that I have read, understood, and agree to the above terms and conditions.
