APPIC New Training Director Mentor Request Form
APPIC offers the opportunity for internship and postdoctoral training programs who wish to design their training programs to move towards membership in APPIC or for current APPIC members to be assigned a Mentor at no cost.  A mentor can be useful to licensed psychologists who are coordinating training for the development of a NEW psychology internship program or one that is PREPARING to submit their materials for APA Accreditation or APPIC membership.  

This form is NOT for students or non-licensed psychologists searching for an internship/postdoctoral fellowship.  Those licensed psychologists interested in developing a training program can complete the information below.  Note that it will take some time to find a match due to an increasing demand for mentors.  An APPIC Board member will contact you as soon as possible, hopefully within two to three weeks.  
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Email *
YOUR First Name - Last Name *
Email Contact *
Daytime Telephone Number *
City, State *
Where will your training program be located?
Which program - Internship or Postdoc?
APPIC provides a mentor for those wanting to become members of APPIC or to become APA accredited.
Are you currently a Training Director of an APPIC member internship or postdoctoral program?
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Identify What You Would Like from a Mentor
Please check those items that are most relevant to you.
Please identify your program's setting
This helps us find a match from a similar site
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