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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

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