Application for LPC-Associate

Application for LPC- Associate
Personal Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Educational Background
Current or Recent Academic Institution:*
Program of Study:*
Semester Level:*
Expected Graduation Date:*
Have you taken and Passed your NCE?
If yes, do currently have a Supervisor?
Interest and Qualifications:
Why are you interested in completing your internship at Hamilton Counseling and Consulting?*
Describe your experience and interest in providing clinical services for children, adolescents, and adults.*
Working as part of a dynamic team is important at Hamilton Counseling and Consulting. Please share your experiences collaborating with others in a professional setting.*
Elaborate on your desire to develop and improve your clinical skills during your internship.*
References:

Please provide the names and contact information of two academic or professional references who can speak to your qualifications and potential as a practicum student.
Reference #1
Name*

First NameLast Name
Relationship*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Reference #2
Name*

First NameLast Name
Relationship*
Email*
Phone Number*
Resume and Cover Letter:

Upload a copy of your resume, a copy of a de-identified written Clinical Case Conceptualization, and a cover letter.
File Upload*

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Hamilton Counseling and Consulting does not accept LPC-Associates with external supervisors, nor do we offer supervision to associates who own a private counseling practice. By submitting this application, you affirm that the information provided is accurate and complete. Additionally, you acknowledge that the selection process includes interviews and reference checks.
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Application for LPC- Associate

Personal Information

Educational Background

Interest and Qualifications:

References:

Reference #1

Reference #2

Resume and Cover Letter: