Application Cover Sheet Fall 2020 Match

Name:

Mailing Address (incl. Street, City, State, Zip):

Phone: Email Address:

___________________________________________________________________________________________________________ Complete this form, save it, and upload it to the supplemental materials section of DICAS. Also, mail it with your application fee to:

Nicole Fenn Sodexo Dietetic Internship 115 Pheasant Run, Suite 106 Newtown, PA 18940

Application fee is $50 if applying to one region; $75 if applying to more than one region.

In the column to the right next to the Region(s), rank those regions where you are applying. Do not rank a region where you don’t want to be placed. Ranking more regions will not increase your chances of being matched. Using the textbox to the right of the table, list the major cities and states, within the region, where you prefer to complete the internship.

Regions In order of your preference, rank (1, 2, 3 etc.) only the regions to which you are

applying and willing to be placed. See page 2 of this pdf for details

D & D Code Fall

Match

Region 1A Spring Match only Region 1B 617 Region 2 Spring Match only Region 3 603 Region 4 604 Region 5 Spring Match only Region 6 606 Region 7 607 Region 8 608 Region 9 A 609 Region 9 B 618 Region 10 A 610 Region 10 B 619 Region 10 C 620 Region 11 A 611 Region 11 B 621 Region 12 612

The Sodexo Dietetic Internship offers 8 different concentrations. Please list your top 3 choices in order of preference. Critical Care MNT, Culinary, Diabetes, Leadership, Pediatrics, Senior Living, Weight Management, Wellness

1. 2. 3.

Online Portfolio Address (and Password if your site requires it)

Submit payment with a check or money order and make payable to Sodexo. Do not send cash. Be sure to include your name in the memo line on the check. We do not accept credit cards, PayPal, or Venmo. Failure to submit payment will result in an incomplete application.

Do you plan to apply to the combined URI MS/internship? Place and “x” in the appropriate column

Yes No Maybe

Geographic Preferences List the major cities and states, within the region, where you prefer to complete the internship in the textbox below. See page 2 of this pdf for details on the Regions.

Regions with available locations for the Fall 2020 match Use information below to add to the Geographic Preferences textbox on page 1 of this pdf.

Region 1 A

Availability for the Spring Match only Region 1 B (D&D 617)

Utica (upstate New York)

Region 2

Availability for the Spring Match only

Region 3 (D&D 603)

Metro NY (Suffolk County, Long Island)

Region 4 (D&D 604)

New Jersey (multiple sites throughout northern NJ, central NJ - Trenton area, southern NJ - Camden area) Pennsylvania (Harrisburg, Philadelphia, Allentown area)

Region 5

Availability for the Spring Match only

Region 6 (D&D 606)

South Carolina (Charleston, Myrtle Beach), Kentucky (Lexington)

Region 7 (D&D 607)

Florida (locations throughout the state, including multiple East and West Coast cities as well as Tallahassee and Pensacola)

Region 8 (D&D 608)

Indiana (Fort Wayne, Gary, Lafayette, Noblesville) Ohio (Akron, Elyria, Ravenna, Steubenville)

Region 9 A (D&D 609)

Chicago Vicinity Region 9 B (D&D 618)

Kansas (Olathe)

Region 10 A (D&D 610)

Texas (Greater Houston Area)

Region 10 B (D&D 619)

North Texas Oklahoma Arkansas (Little Rock, Pine Bluff)

Region 10 C (D&D 620)

Central and South Texas

Region 11 A (D&D 611)

Colorado (Denver)

Region 11 B (D&D 621)

Colorado (Grand Junction)

Region 12 (D&D 612)

California (LA Area (Montebello, Arcadia, Simi Valley), Newport Beach, Riverside, Hemet, San Jose) Hawaii (Honolulu) Nevada (Las Vegas)