Graduate Counseling - Self Inventory for Practicum/Internship Site Selection


(form 5)

First name:
Last name:
You will receive an email copy of this form.
  1. My long term career goal is:
  2. My area of special interest is:
  3. The client who I would most like to work with is:
  4. The client who I would least like to work with is:
  5. I feel most qualified/skilled to work with:
  6. I feel least qualified/skilled to work with:
  7. An area of competence I would like to enhance or develop is:
  8. My ideal site supervisor would have the following characteristics:
  9. I feel most comfortable in a working environment with the following characteristics:
  10. I have had the following professional or volunteer experience and/or course work related to counseling:
  11. My personal areas of strength and weakness which should be considered in the site selection process include:
    • Strengths:
    • Areas for improvement:
  12. My ideal counseling internship would be a(n) school/institution/clinic performing duties with (type of population).