Wednesday, 10 Mar 2010
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Graduate Counseling Internship Application
Note:
To complete this form, use IE7 or later.
Name:
*
E-mail address:
*
Phone:
*
For which are you applying?
*
Practicum
Internship
How many hours do you need?
*
Requesting Placement for:
*
Fall
Summer
Spring
Name of school you are attending:
*
Which days of the week are you available?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
When do you anticipate being available?
*
Mornings
Afternoons
Evenings
Which modalities are of interest?
*
Individual Counseling
Group Counseling
Play Therapy
Which client populations are of interest?
Children
Teens
Women
Men
Voluntary
Mandated
School-based
Homeless
Which languages do you speak fluently?
*
English
Spanish
Other
If other, which language(s)?
Program selection:
Family Violence Prevention Services, Inc. wants you to have a meaningful, comprehensive, and challenging practicum/internship experience to further your professional development. You are invited to select as many as two of our major programs from the list below to create a unique and rewarding practicum/internship exprience. Review the information on our webiste, under \"Get Help\" to learn about our Programs.
Choose as many as two:
*
Counseling Services
Violence Intervention Program
Community Based Counseling Program
Reconnecting Youth
Prjoect Towards No Drug Abuse
Celebrating Families
Upload your resume as MS Word,Adobe PDF, or plain text:
*
