MA Community Counseling Program

Practicum and Internship

All students should familiarize themselves with the Practicum and Internship Training Manual prior to applying for practicum. This is critical for understanding the practicum and internship requirements, the application process, and professional/academic responsibilities throughout the training process. Students should review the Training Manual again prior to the start of their practicum training to ensure that they have the most current information and the required forms. Practicum and internship forms are also available below.

Training Documents

• Training Manual (Updated November 2010)
• Timeline for Practicum and Internship
• Practicum Intent Form
• Request for Letter of Recommendation
• Practicum Placement Request Form

Professional Development Signature Sheet

In order to complete the application for Practicum and Internship process students must also submit to the Training Coordinator the following:

• Student’s current resume
• A statement of the student’s goals and interests

Development of a New Site

• Training Site Guidelines
• Site Information Form (to be filled out by Site)

General Forms

• Agreement Form
• Authorization for Release of Information
• Professional Liability Certificate (if insurance requested)

Practicum Forms

• End of Practicum Hour Log
• Monthly Practicum Hour Log
• Practicum Individual Supervisor Evaluation Form
• Practicum Portfolio Evaluation Form
• Practicum Seminar Leader Evaluation Form
• Practicum Site Supervisor Evaluation Form
• Practicum Student Evaluation of Site
• Practicum Student Perception of Site Supervisor
• Practicum University Activity Monthly Hour Log
• Practicum University End of Hour Log

Internship Forms

• Internship Hour Log
• Internship Monthly Site Hour Log
• Internship Seminar Leader Evaluation Form
• Internship Site Supervisor Evaluation Form
• Internship Student Evaluation of Site
• Internship Student Perception of Site Supervisor
• University Activity Monthly Internship Hour Log
• University Internship Hour Log

Counselor Competency

• Counseling Competence Examination Evaluation Form
• Remediation Plan