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Practicum/Internship Application Process List of Approval Documents Degree Completion Plan Audit Background Check Receipt Supervisor’s License Verification Fieldwork Contract Supervisor Information Form and Site Information Form Photo Liability Insurance Face Sheet Affiliation Agreement Degree Completion Plan Audit Located in ASIST Click on “Student” tab Click on “Student Record” Click on “Degree Completion Plan Audit” Click on “Save As PDF” Maximize the screen Click on the Download button to download the Degree Completion Plan Audit as PDF Or Right Click and “Save Page As” to save as a PDF file Save As: Last name_First name_DCPA Background Check Receipt Counseling Background Check: https://portal.castlebranch.com/LM71 Example on the next page Castle Branch Background Check Receipt Supervisor’s License Verification Most students can receive this for free from their state counseling board website On state counseling website it be a link for License Lookup or License Verification Information our office looks for: Supervisor’s Name Type of License License Number Issue Date Expiration Date Current/Active Louisiana and Nevada: Contact state counseling board West Virginia: Need a copy of the actual license with the information above Fieldwork Contract Use the Practicum Fieldwork Contract Template or Internship Fieldwork Contract template located on the Practicum website or Internship website Use the exact wording on the Fieldwork Contract Template Dates in the Fieldwork Contract should reflect the full A-Term semester dates See Academic Calendar on the Registrar’s Office website- see link below http://www.liberty.edu/academics/registrar/index.cfm?PID=17813 New York Students Only: Please use the approval documents indicated for New York Students only on the Practicum website or Internship website Wet signatures/signed with pen Supervisor/Site Information Forms Two separate forms located on the Practicum or Internship website Need to be completely filled out prior to submission Director of Site Can be the same as potential supervisor Director of the program if site is a large site such as a treatment center/hospital New York Students Only: Please use the approval documents indicated for New York Students only on the Practicum or Internship website Supervisor: needs to be full licensed Boxes need to be checked as well as filled in with the necessary information Ensure box about Group Supervision and 2-year Clinical experience are checked Need wet signatures/signed with pen Save both pages as one PDF file Photo Driver’s License, Student ID, or Professional Photo Clearly visible of the student’s face File type: JPG or PDF file Liability Insurance Face Sheet Insurance in the student’s name and not in the name of the site Amounts: $1 million per occurrence and $3 million aggregate AACC: Master policy effective dates must be current for the semester the student is applying for or covers for half of the semester HPSO: “Certificate of Insurance” is the document our office requires Examples of the Liability Insurance Face Sheet are located in a PDF file on our Practicum/Internship websites Some organizations students can contact about insurance include: Healthcare Providers Service Organization (HPSO) 1-800-982-9491 or hpso.com (preferred) American Association of Christian Counselors (AACC) 1-800-526-8673 American Counseling Association (ACA) 1-800-545-2223 (can also be helpful for Canadian students) (preferred) American Professional Agency, Inc 1-800-421-6694 Affiliation Agreement Only the site completes the first portion of the Affiliation Agreement Students only complete the Student Addendum The name of site and site’s address in the blanks under 12.0 Notice in the Affiliation Agreement Leave section under Liberty University blank on the signatory page Sites must complete a W-9 Form as part of the Affiliation Agreement Please attach the W-9 Form as one of the pages for the Affiliation Agreement Submit all pages of the Affiliation Agreement as one PDF file Wet signatures/signed with pen Sites can use their own Affiliation Agreement Sites can contact Internship team at internship@liberty.edu to use their own Affiliation Agreement Further instructions located in the following link: http://www.liberty.edu/media/1118/Instructions_for_Affiliation_Agreement pdf How to submit a Practicum/Internship Application through SharePoint Use the submission portal link on the Practicum website (http://www.liberty.edu/index.cfm?PID=28215) or Internship website (http://www.liberty.edu/index.cfm?PID=6333) The submission portal link will be posted under the deadlines listed on the websites Students are to use their Liberty University email (including “@liberty.edu”) and password to log in to SharePoint to submit either a Practicum application and approval documents or an Internship application and approval documents Save Approval Documents on desktop as PDF files There is a designated spot for each of the approval documents; therefore, save the Degree Completion Plan Audit as a separate document from the student’s Background Check Receipt PDF file, Supervisor’s License Verification, etc WebEx (60 hour Professional Counseling program ONLY) All sections of COUN 698 Practicum and COUN 699 Internship Exceptions: the Marriage and Family Therapy degree program and the 48-hour Professional Counseling degree program students will not be enrolled in WebEx Faculty Group Supervision Submit times when you submit your Practicum/Internship application 1.5 hours of Weekly WebEx Faculty Group Supervision Reason- the department’s decision to begin the process of seeking CACREP accreditation for the online 60-hour Professional Counseling degree program WebEx Time Preferences Our office cannot guarantee that you will placed based on your time preferences The Faculty Supervisor will set the specific day and time and notify students of the day and time Time Preferences are: Weekday Morning Weekday Afternoon Weekday Evening Weekend Morning Weekend Afternoon Weekend Evening Students are to provide our office with two separate time preferences Review Process Our office reviews applications in the order they are received Students are to check their Liberty University email daily for any additional updates If corrections are needed, our office will email students’ Liberty University email with instructions and a new resubmission deadline Submit corrected approval documents via email and by the student’s extension deadline our office gives to students in their Initial Review email The Review Process usually takes to weeks including the time between emails from our office to students However, the Review Process may take longer at times Please not email our office to received confirmation of receiving your Practicum/Internship applications Our office will manually register students once their applications are approved Important Websites and Email Addresses Practicum: http://www.liberty.edu/index.cfm?PID=28215 Email: practicum@liberty.edu Internship: http://www.liberty.edu/index.cfm?PID=6333 Email: internship@liberty.edu