Master's Counselor Internship Inquiry

Master's Counselor Internship Inquiry
Disclaimers: (1) We take on student counselors every other semester/academic term as we REQUIRE a two semester committment from a student counselor. (2) We recommend student counselors who are interested in our site, that they do not have a full-time job as it makes it difficult for the student at our site.
I have READ the above disclaimer before completing the Inquiry Form.*

YESNO
Full Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Are you attending a CACREP program?*

YesNoUnknown
What type of supervision are you seeking?*

Master's Level Student PracticumMaster's Level Student Internship Supervision
When are you seeking to begin?*
Are you able to commit to two academic terms (back-to-back)?*

YESNO
What is/are your theoretical orientation(s) you have a passion for and why?*
What is your counselor identity?*
Have you taken a DSM5 class?*

YESNO
Are you available for FOUR hours of administrative hours per week in-office?*

YESNO
What is your clinical availability?*
NOTE: Having a full-time job will make matching with our site difficult.
Comfortable with in-person or virtual services?*

YESNO
Clinical Supervision*

Monday's @ 4pmWednesday's @ 4pmFriday's @ 4pmNo Preference
COVID Screening: Are you currently fully vaccinated?*

YESNO
References (Please list three references with name, email address, and phone):*
NOTE: DO NOT USE FRIENDS OR FAMILY
Best day/time to be contacted?

MonthDayYearHourMinutesAM/PM Option
Upload Resume*

Upload a File

Cancelof
Note: This is NOT for employment. This inquiry screen is ONLY to submit interest in a Master's level Counseling program internship.
Additional Resources:

Supervisor(s):

https://www.psychologytoday.com/us/therapists/supervision-services

Military Spouses (Supervision Reimbursement):

https://www.militaryfamily.org/licensing-certification/

Veterans (Licensing Exam Reimbursement):

https://www.vba.va.gov/pubs/forms/VBA-22-0803-ARE.pdf
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