Application for School Counseling Practicum/Fieldwork Placement
I agree to the following:
-I will provide my Certificate of Clearance, my most current TB skin test, and Certificate of Mandated Reporting Training to Maricela Reyes in Human Resources. I understand I cannot complete hours until I have been cleared by Human Resources;
-I understand that I will interview with the school counselors who are seeking an intern and if chosen will start my hours at that school;
-I will attend my practicum/fieldwork internships on dates agreed upon by my counselor supervisor;
-I will adhere to the ASCA National Model -a framework for school counseling programs as I engage in a broad and diverse range of activities;
-I will set a professional example of the Counseling Department in my relationships with people and in my dress code;
-I will respect confidentiality, legal and ethical codes when dealing with students , parents and staff.
Your first and last name *
Your answer
Email *
Your answer
Phone Number *
Your answer
University you are attending *
Your answer
University supervisor *
Your answer
University supervisor contact number *
Your answer
University supervisor contact email
Your answer
I am needing to complete *
Need High School Placement? *
How many hours?
Your answer
Need Middle School Placement? *
How many hours?
Your answer
Approximate Start Date
Your answer
Approximate End Date *
Your answer
Anything else you would like for us to know?
Your answer
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