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Self Inventory for Practicum/Internship Site Selection
(Form 5)
First name:
Last name:
Email:
You will receive an email copy of this form.
My long term career goal is:
My area of special interest is:
The client who I would most like to work with is:
The client who I would least like to work with is:
I feel most qualified/skilled to work with:
I feel least qualified/skilled to work with:
An area of competence I would like to enhance or develop is:
My ideal site supervisor would have the following characteristics:
I feel most comfortable in a working environment with the following characteristics:
I have had the following professional or volunteer experience and/or course work related to counseling:
My personal areas of strength and weakness which should be considered in the site selection process include:
Strengths:
Areas for improvement:
My ideal counseling internship would be a(n)
school/institution/clinic performing
duties with
(type of population).
Information:
501-279-4000
Address:
Harding University
915 E. Market Ave.
Searcy, Arkansas 72143
Copyright © Harding University,
915 E. Market Ave. Searcy, Arkansas 72149