NDSU Counseling Center Application for Graduate Student Training Position

Application Deadline: February 2010

Please address any questions about the application process to Marlys Borkhuis, M.S. (Training Director) at (701) 231-7671.

Name:*

Email:*

Address:*

Phone:*

In what graduate program are you enrolled?*

Please attach cover letter:*

Please attach resume:*

What courses have you taken (up to this time) in your program?*

What courses will you be taking next year?*

Please provide the name, title, phone number and email address of someone who knows your work in a previous internship/practicum/fieldwork setting (such as a previous practicum advisor or supervisor). Please note that this and/or other references may be checked at our discretion.*

Does the type of placement you are seeking best fit into the category of practicum, internship, fieldwork, or some other category?*

How many hours does your program require that you spend in your internship/practicum/fieldwork experience?*

Does your on-site supervisor need to have a specific licensure? If so, what licensure would that be?*

Are you currently aware of any time commitments you will have next year during the week that would prevent you from being in the office during those times? Any information that you can offer is helpful as we look to next year's scheduling of graduate students.*

What clinical counseling practical experience have you had? Please elaborate:*

What practical experience have you had providing "helping" services? Please elaborate:*

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Last updated: Tuesday, September 08, 2009 10:12:52AM

Site Manager: NDSU Counseling Center
Published By: NDSU Counseling Center

Counseling Center
NDSU Dept. 5120
P.O. Box 6050
Fargo, ND 58108-6050
Phone: (701) 231-7671
ND Relay: (800) 366-6888
Fax: (701) 231-6318
Location: 212 Ceres Hall