CCCA Internship Application

1
Applicant Name* This field is required.
First Name
Last Name
2
Practicum Requirement* This field is required.Does your school require you to complete a 100-hour practicum experience prior to internship?
YESNO
3
Practicum Completion* This field is required.Have you completed your 100-hour practicum experience
Yes - I'm ready for my 600-hour Internship
No - I'm applying to begin my 100-hour Practicum
No - I'm completing my 100-hour practicum somewhere else and applying to complete my 600-hour Internship here in the future
4
Internship Requirements - Hours* This field is required.An internship at CCCA requires a 2 semester commitment and completion of 240 direct client hours - regardless of hours earned at other site(s) prior to or concurrent with a student's time at CCCA. LPC and MSW students should count on 240 direct client hours and 360 indirect hours. MFT students should count on doing 240 client hours in 2 semesters or 360 hours in 3 semesters. If a student's university requirements are greater than these, the more stringent requirements will apply.
I can make this workI cannot make this work
5
Internship Requirements - Scheduling & Time on Site* This field is required.An internship with CCCA requires 16 hours a week on site. These 16 hours must be scheduled in 4 separate, 4-hour blocks with two daytime and two evening blocks (evening = anything after 4 pm or later) on at least three different days of the week. Interns are free to set their own schedules within these parameters and may see clients any day of the week. In addition, interns meet with their supervisors for at least one hour per week. Sample Schedule: Tuesday: 4:30p-8:30p (1 evening) Wednesday: 12pm-4pm, 4pm-8pm (1 daytime, 1 evening) Saturday: 9am-1pm (1 daytime) This = 4 shifts (2 daytime; 2 evening) on 3 different days.
I can make this workI cannot make this work
6
Email* This field is required.
example@example.com
7
What school are you attending?* This field is required.
8
Please select the semester/month that best fits when you are applying to start.* This field is required.
Spring 2023 (January/February)
Summer 2023 (May/June)
Fall 2023 (August/September)
9
Total Hours* This field is required.How many TOTAL hours (direct + indirect) does your program require?
10
Direct Hours* This field is required.How many DIRECT hours does your program require?
11
Group Requirement?* This field is required.Does your program require you to obtain experience leading a group?
Yes
No
12
Group Requirement - DetailsPlease provide details about your program requirements for group experience (hours, type of group, etc.)
Huge
Large
Normal
Small
Ok
Ok
13
Any other program requirements we should be aware of?
Huge
Large
Normal
Small
Ok
Ok
14
Cover Letter* This field is required.Please upload a cover letter below:
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Max. file size: 10.6MB
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15
Resume* This field is required.Please upload a copy of your resume below:
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Max. file size: 10.6MB
Cancelof
16
Signature* This field is required.I acknowledge that I have read and understood CCCA's hours and scheduling requirements as described above and believe I will be able to meet these requirements.
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