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Reservation Form

(Form 3)

All candidates in Counseling must complete and submit this form at least one semester before enrolling in the selected class.

Class to reserve:


First name:
Last name:
Email:
You will receive an email copy of this form.
Home phone:
Work phone:
Cell phone:
Address:
City:
Zip:
H#:

I plan to enrole in this class in (semester and year):

Please select a class above to continue with this form.

The following courses passed with a minimum grade of B are minimum prerequisites to COUN 611. Please indicate the semester each course was taken and your grade:

Course Semester/Year Grade
COUN 601 Counseling Theories
COUN 602 Counseling Techniques
Choose 9 hrs from the following:
COUN 603 Clinical Judgment
COUN 606 Assessment
COUN 607 Crisis Counseling
COUN 608 Adv. Human Growth Dev
COUN 610 Groups
COUN 677 Law/Ethics

Please indicate when you completed or plan to complete the following (sem/yr):

Course Semester/Year
COUN 600 DSM
COUN 604 Professional Identity
COUN 605 Career Counseling
COUN 611 Practicum
COUN 613 Internship
COUN 645 Multicultural Counselingand/or
EDFD 645 Social/Cultural Issues or
SWK 510 Human Diversity
EDL 649 Ethics (2hr. Bible)
EDFD 652 Research
COUN 656 Alt. and Experiential
COUN 660 Prin. Rehab. Coun.
COUN 661 Med./Func./Env. Disability
COUN 749 Ethical Coun. Prof. (2hr. Bible)
COUN 680 Coun. And Abnormal Psyc.
COUN 684 Family and Relationship

Please place an asterisk (*) next to courses you plan to take concurrently with COUN 611.
Please Note: All prerequisites must be completed prior to enrollment in practicum. You cannot enroll in COUN 613 if you have earned a C or below, or if you have an Incomplete (I) in 611.

Please note there are prerequisite and co-requisite courses for COUN 613. All prerequisites/co-requisites must be completed prior to the semester in which you enroll in internship.

Please indicate the semester COUN 611 Practicum in Counseling was taken:

Semester/Year
Grade

List courses (if any) that you plan to take concurrently with COUN 613:

Other requirements and before acceptance into the practicum semester:

  • School Counselors may be asked to complete a Criminal Background Check with the State Police Department. (Sites other than schools may also ask for a criminal back ground check.)

Please note there are prerequisite and co-requisite courses for COUN 787. All prerequisites/co-requisites must be completed prior to the semester in which you enroll in advanced internship.

Please indicate the semester COUN 613 Internship in Counseling was taken and completed (6 hours):

Semester(s)/Year(s)
Grade(s)

List courses (if any) that you plan to take concurrently with COUN 787:

Other requirements and before acceptance into the practicum semester:

  • School Counselors may be asked to complete a Criminal Background Check with the State Police Department. (Sites other than schools may also ask for a criminal back ground check.)

Dr. Jenene Alexander, Director
Counseling Program
College of Education
Harding University
Box 12254
Searcy, AR 72149
gradcounseling@harding.edu

professionalcounseling@harding.edu

schoolcounseling@harding.edu