ࡱ> TVS AbjbjVV 4N<<u \3l#0bZ\\\\\\$Sr] ZZ4oF0#g(gg(#g : Application for Internship School Counseling Directions: Complete the entire application. Fill out each box. Attach your resume and a copy of your most recent academic transcript. Applications with missing information will not be considered for any internship. Return this completed form to the Practicum and Internship Committee Chair. The deadline to submit this form is on or before March 17th by 5:00 pm. Thank you for your time. Name (Last, First, Middle):  FORMTEXT      RU Student Id #  FORMTEXT      Street Address:  FORMTEXT      City, State & Zip:  FORMTEXT      Email :  FORMTEXT      Home Phone:  FORMTEXT       Work Phone:  FORMTEXT      Other Phone:  FORMTEXT       Indicate semester and year when you entered the program:   FORMCHECKBOX  Summer or Fall  FORMTEXT       YearProspective graduation date:  FORMCHECKBOX  December  FORMTEXT       Year  FORMCHECKBOX  May  FORMTEXT       YearIndicate the semester and year in which you plan to be enrolled in internship:1st Internship: Semester:  FORMTEXT       Year:  FORMTEXT      2nd Internship: Semester:  FORMTEXT       Year:  FORMTEXT       If approved by the Practicum and Internship Committee, are you interested in using your current employment as your internship?  FORMCHECKBOX  Yes  FORMCHECKBOX  NoIf YES, what is your current job title & employer?  FORMTEXT       Preferred School Counseling Setting All school counseling students will be enrolled in two internships, one of which will be an elementary school. Choose either a middle school or high school setting for the second internship. Please note that there may be times when your preferences (e.g., wither middle or high school) are not available. Students will be notified of their placement. Check one of the following options:  FORMCHECKBOX  Middle School  FORMCHECKBOX  High School Preferred Public School District Indicate your district preferences and prioritize your top three preferences (e.g., 1st, 2nd, and 3rd).  FORMTEXT ",-.9\]op{ & * 1 3 B L T x zjzzaYh CJaJhUh CJ hUh H*OJQJ\^Jh OJQJ\^Jh`h OJQJ\^Jh`h OJQJ^J#h&h 5CJOJQJ^JaJh CJOJQJ^JaJ h&h CJOJQJ^JaJ&h&h 5>*CJOJQJ^JaJh CJOJQJaJhnjh CJOJQJaJ"-.  . 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