Renewal Contract Submission Form

Renewal Contract Submission Form
Is this a contract for practicum or internship supervision?*

YesNo
Which Department or Clinic?

School of Professional PsychologyCenter for Behavioral Health (and any CBH sub-clinic)School of Social WorkOther
STOP: Please contact Catherine Bendl at cbendl@spalding.edu to attain the new Standard SOPP Practicum Contract.
Primary Contact/Project Director (person completing this form)*

First NameLast Name
Primary Contact Email*
example@example.com
Chair or Supervisor of Primary Contact/Project Director

First NameLast Name
Chair or Supervisor Email
example@example.com
Department/Program*
Funding/Partner Organization*
Project/Contract Start Date*

MonthDayYear
Date
Project/Contract End Date*

MonthDayYear
Date
Briefly describe the proposed project, how it fits the university mission and benefits our students.
Will the contract provide payment to individuals? (either current employees, new hires, or external contractors)*

YesNo
Will the contract provide payment to students?*

YesNo
Upload most recent contract

Most recently fully executed contract (usually from prior year)
Cancelof
Upload new contract

New version of the renewing contract
Cancelof
If a separate budget exists for this contract, please upload it here.

Cancelof
If changes have been made from previous years' contract, please outline changes below.
Signature

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