Form

Form 1000: Application for Practicum and Internship
This application, when approved, reserves a space for you in the 8-hour semester practicum/internship sequence
In order to graduate Mental Health , Professional and Rehabilitation Counseling students need:1) Two semester hours of CPS 7660 or CPS 7663 (fall term mini-mester 1) 2) Six semester hours of CPS 7680 or CPS 7683 (fall mini-mester 2 and spring semester)This course sequence is taken consecutively. Courses in the sequence cannot be taken in the same semester.
Program of Study:
Catalog year you are following:
Entry Semester
Year
Expected Graduation Semester
Year
Semester you plan to begin internship:
Have you secured a practicum site?

Yes No
Please fill in your student information:
E-mail
Full Name
First Name Last Name
Panther ID*

Address