Certificate of Endorsement - Professional Supervisor (For Supervisor in Training)

Certificate of Endorsement - Professional Supervisor

For AASECT Supervisor-in-Training | This form can be used for Supervisors that provided any amount or type of supervision to the applicant. Please note that some sections indicate that they are required for the applicant's PRIMARY Supervisor.
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You can also contact us at certification@aasect.org.
Applicant's Name*
Supervisor's Name*
I endorse the above Applicant as a:*
Please select your current status with AASECT:*

I am currently an AASECT Certified Sexuality EducatorI am currently an AASECT Certified Sexuality CounselorI am currently an AASECT Certified Sex TherapistI am currently an AASECT Certified Supervisor
I have known the applicant for number* years.
I supervised the applicant from (start date to end date):*
Start date to end date
If you were the applicant's Primary Supervisor - I supervised the Candidate for (enter number below) hours per month.
Hours per month
We completed #* hours of individual supervision and #* hours of group supervision.
The setting(s) for the supervision provided was/were*
The Candidate performed #* hours of * under my supervision.
My signature below indicates that:
- I certify that my applicable license and/or certificate(s) have been current and in good standing throughout the supervisory term.
- I certify that I reviewed the applicable license and/or certificate(s) of the Candidate and found them to be in good standing throughout the supervisory term.
- If I provided more than 5 hours of supervision to this Candidate, that I have provided them with a letter of endorsement highlighting my experience as the professional Supervisor of the Candidate, the nature of our professional relationship, and my overall impressions of their strengths, competencies, and readiness to be certified as a Supervisor, as well as any challenges that may impair competence.
Name *
Title*
Address (Street)*
Address (City, State, Zip/Postal, Country)*
Telephone*
Email*
example@example.com
Signature*

Clear
Date*

MonthDayYear
Date
Please use the "Preview PDF" button below to download a copy of your completed form. Provide that form to the Candidate to include with their AASECT Certification application.
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