New Internship Site Request Form

This form is used to request the development of a New Internship Site. This would be for a Site not currently partnered with The Seattle School and not listed in our Internship Resource Guide.

General Process: Once this form is submitted, the Field Experience Coordinator will review the form submission and follow up with the site and student as needed. The Clinical Internship Committee determines final approval of new sites. Students will subsequently be informed about the status of their New Internship Site Request by email. Only once an internship site is approved can students proceed with the Internship Start Forms (see Appendix A).

NOTE: Students may choose to apply and interview with a New Site while it is under review. However, students must make clear to the site that they may not accept an offer until the site has been approved.

If you change your mind about a site and want to remove it from your ranking list please email the Field Experience Coordinator directly.

Students Interested in Global Internship Sites: Please note that completing this form DOES NOT commit you to completing your internship at a Global site, nor does it guarantee that The Seattle School will find an International site for you.

Once you complete this form, the Field Experience Coordinator will contact you and schedule a Zoom meeting. This meeting will inform you of the Application Process for a Global Internship. You will have an opportunity to ask questions specific to a Global Internship. Specifics (languages you speak, global travel experiences, etc.) will be discussed.

Student Name*

First NameLast Name

Student Email*

example@example.com

Current term & year*

e.g. Fall 2024

Expected internship start date (term & year)*

e.g. Fall 2025

I have reviewed Section 6 (Internship Site Requirements) of the Internship Handbook and agree that this site meets those basic requirements.*

Yes

Contact Name*

First NameLast Name

Contact Email*

example@example.com

Contact title/position*

Site name*

Site Web Address (URL)*

Is this site outside of the United States?*

YesNo

Site Location: City*

Site Location: State*

Site Location: Country*

Application due date*

If there is not a specific date listed, please enter N/A.

Prospective Supervisor Name*

Site Supervisor License/Credential Type*

Typical number of Interns accepted per year*

What kind of supervision does the site offer? (1:1, dyadic, group, etc.)*

Is supervision weekly?*

YesNo

If not, how often is supervision provided?

Is the supervisor available for consultation and support when interns meet with clients?*

YesNo

If no, please explain.

What is the average client caseload for interns?*

What is the expected speed of building an intern's caseload at this site?*

What is the site's process for screening and assigning clients for new interns?*

Describe the site's onboarding process.*

List any additional seminars or regular training.*

Attach the site's Internship Handbook/Manual.*

Any additional materials related to this site may be uploaded here for review.

Rank order of the site (i.e., first choice, second choice, etc.)*

New Internship Site Request Form

Prospective Internship Site: Basic Information

Prospective Internship Site: Internship Program Details