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Acknowledgement of Site Supervisor Responsibilities, Orientation and Training

I have thoroughly reviewed both the Student Handbook and The Field Experiences Handbook for Practicum, Internship, and Advanced Internship for the Harding University Professional Counseling Program.

I understand that Practicum students must log 200 hours, 80 of which must be direct counseling hours. I understand that Internship students must log 600 hours, 240 of which must be direct hours. I understand that Advanced Internship students must log 150 hours for every 3 credit hour they take, 60 of which must be direct hours.

I have read through the roles and responsibilities of a site supervisor and understand and agree that I must provide one hour or weekly direct supervisor with my practicum or internship student. I have also read through the expectation of students and faculty supervisors and acknowledge that I understand the roles and responsibilities of each member of this educational team.

I have completed the supervision training video.

I have reviewed all forms and acknowledge that I am qualified to supervisor the practicum or internship student.

I know that if I have and questions I am to contact either Mr. Josh Strickland or Dr. Marc Fager at Harding University.

First Name:
Last Name:
Email:
You will receive an email copy of this form.
Last 4 Digits of SSN:

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