Instructions for Completion of the Applications for Fieldwork in School Counseling and the Paid Internship Credential

Transcription

1 Instructions for Completion of the Applications for Fieldwork in School Counseling and the Paid Internship Credential **This application is to be completed for PAID Internship positions only. Otherwise, use the Application for Fieldwork in School Counseling Form. 1. Complete pages 1 and 2 of the Application. a. Document can be completed: i. Electronically by typing in the fillable spaces with the use of Adobe Reader or Adobe Acrobat installed on your computer. 1. If you do not have Adobe Reader, it is free and can be downloaded here: ii. Document can also be completed in writing. 2. Print out a copy and obtain the following signatures: a. Student signature on page 1 b. University Fieldwork Supervisor signature on page 1 c. Site Fieldwork Supervisor signature on page 2 3. Make a copy of your application for your personal records. 4. Turn in the following to the Division Office by the 5 th week of the Quarter preceding fieldwork placement: a. Completed Application b. Preceptor Contract c. Make a copy of the application for your University Supervisor Paid Internship Credential Application Checklist The following must be on file with the Division Office prior to the start of any supervised fieldwork through the Paid Internship Credential Program. Copies must also be turned in to the University Fieldwork Supervisor. Paid Internship Credential Program Application for Fieldwork In School Counseling including Site Supervisor Contract (pages 1 & 2) Preceptor Contract (page 7) District letter in support (page 8) District Offer of Employment letter (page 9)

2 APPLICATION FOR FIELDWORK IN SCHOOL COUNSELING This Application is for: COUN 586S COUN 586W Quarter Year Total # of units (All Sites) Student's Name: CIN# Phone: (Home) (Work) Address: City Zip Do you have a tentative Fieldwork placement? YES NO Location Fieldwork Site Name: Address: City Zip Fieldwork Site Student Phone Number: Site Supervisor: Title: Phone: Is this your 1st Quarter of Placement at This Site? YES NO Specify quarters placed at this site: # of hours this quarter: Type of Work Expected at This Site: I certify that I have: Completed the following courses with a grade of B or better: COUN 400A, 428,460,501, 503, 505, 506, 557, 581 Passed the CBEST (attach copy to this application) Obtained a Certificate of Clearance or hold a valid California Teaching Credential (attach copy to this application) Read the Fieldwork Manual and understand my obligations as a fieldwork student as described in the Manual. Student's Signature: Date: I approve this student's fieldwork placement as described above.word did not find any entries for your table of contents. CSULA Fieldwork Supervisor Signature: Date: 1

3 FIELDWORK SITE SUPERVISION CONTRACT I agree to provide on-site professional supervision in School Counseling for: Student's Name: Quarter: Year: I acknowledge that I have met the following qualifications as a Site Supervisor. I have held a Pupil Personnel Services Credential with Advanced Authorization in School Counseling for at least two years (attach copy of credential). I have worked in the setting in which the supervision is taking place for at least one year. I will be able to devote a minimum of one hour of individual supervision per week. I am aware of the competencies the student must meet as part of the fieldwork experience. I agree to one site visit per quarter by the CSULA University Supervisor. Fieldwork Site Location: Fieldwork Site Supervisor Name: Site Fieldwork Supervisor Signature: Date: CACREP standards require that the university have a resume of the Site Supervisor on file. Please attach a brief resume with this letter of agreement if you do not have one on file. Please Check: My resume is attached. My resume is already on file. 2

4 SCHOOL COUNSELING INTERNSHIP CREDENTIAL Requirements for Admission: Candidates for admission to the program must: 1. Meet all university, college, and division requirements 2. Be employed at least halftime in a position that requires School Counseling or Child Welfare and Attendance responsibility. 3. Those interns who require the internship credential must pass the California Basic Educational Skills Test (CBEST) and the Writing Proficiency Examination (WPE). 4. Agree in writing to make regular progress, while serving as an intern, toward fulfilling all requirements for the clear credential. 5. Must have completed all prerequisites to the program. 6. Must be enrolled in the master program and have completed 19-quarter units in the following classes: COUN 400A, COUN 501, COUN 503, COUN 505, and COUN Must have completed 6 units of Practicum in the following classes per option: SBFC: COUN 523 (6 units); SCL: COUN 507 and Must have completed a minimum of 18-quarter units in residency in counseling required classes. 9. Must hold California Certificate of Clearance. 10. Must enroll in fieldwork supervision, COUN 586S, for at least three (3) units each quarter of practice as a counseling intern. 11. Must complete a minimum of 200 hours at a second grade level for all fieldwork students. A Preceptor may be used for The Preceptor is the Site Supervisor at the second grade level that will be supervising your hours at the second site. Completion of the PRECEPTOR CONTRACT (attached to this document, page 6) must be completed and submitted. 12. Must complete the School Counseling Internship Credential Application from the Office of Student Services. Click on the following link: Apply for a Credential 3

5 The Cooperating School District must take the following actions: 1. Establish a District Internship Advisory Committee (DIAC) consisting of lay non-educators (e.g., Parents, community leaders), educators and interns. This committee will advise the district regarding its intern program. 2. Select members of its DIAC to serve on the University Internship Program Council. This member should be authorized to represent the district and perform a liaison role with the appropriate professional association represent counselors. 3. Submit a letter of application (see Appendix A), including a request for granting the internship credential and admission to the program, on behalf of the candidate, as well as written confirmation of the creation and composition of the DIAC and the date for implementation of the intern credential. This letter must come from superintendent or designee. 4. Submit an outline of the job specifications associated with the intern s responsibilities. 5. Agree to release the intern for the equivalent of one day per month for field visitation without loss of salary or need for compensating time. 6. Submit a letter of offer of employment as school counseling from the school district (see Appendix B). 4

6 INTERNSHIP CREDENTIAL PRECEPTOR CONTRACT A minimum of 200 hours of fieldwork completed at a second grade level are required of all fieldwork students. A preceptor contract is required for students in the internship credential program that are completing school counseling hours at a second grade level, but are primarily supervised by their fieldwork site supervisor at their internship credential site. An on-site supervisor at the second grade level site is required. A preceptor contract is required to be completed for the on-site supervisor of the secondary site. Fieldwork hours at the secondary site should be logged and maintained separately from the primary site and signed off by the preceptor. I understand that this student is participating in the Internship Credential and the primary Fieldwork Site Supervisor is: PRIMARY FIELDWORK SITE SUPERVISOR NAME: PRIMARY FIELDWORK SITE SUPERVISOR SCHOOL: PHONE NUMBER: I agree to provide on-site professional supervision as a PRECEPTOR in School Counseling for: Student's Name: I acknowledge that I have met the following qualifications: I have held a Pupil Personnel Services Credential with Advanced Authorization in School Counseling for at least two years (attach copy of credential). I have worked in the setting in which the supervision is taking place for at least one year. I am aware of the competencies the student must meet as part of the fieldwork experience. I agree to one site visit per quarter by the CSULA University Fieldwork Supervisor. PRECEPTOR NAME: PRECEPTOR SITE LOCATION/ SCHOOL: PHONE NUMBER: On-Site Supervisor PRECEPTOR Signature Date: CACREP standards require that the university have a resume of the Site Supervisor on file. Please include a brief resume with this letter of agreement if there is not already one on file with CSULA. Please Check: My resume is attached My resume is already on file. 5

7 Appendix A: Example of letter of application for requesting internship credential program Date DISTRICT LETTERHEAD [Insert University Faculty Name, CCOE, CSULA] Division of Special Education and Counseling, 5151 State University Drive, KH C-1064 Los Angeles, CA Dear [Insert University Faculty Name]: This letter is written to express our support and willingness to participate in the School Counseling Internship Credential program in the Charter College of Education at California State University, Los Angeles. I have had an opportunity to review the content of your program. In the event that we employ a school counselor with an Internship Credential stipulate the District will provide the following as required by the California Commission on Teacher Credentialing: 1. We will supervise the intern as described above. 2. Intern s salary (check one): We will not reduce an intern s salary to pay for supervision. We will not reduce an intern s salary by more than 1/8 to pay for supervision. 3. If the intern s salary is reduced, the supervisor will have no more than 8 interns. 4. The District will provide support personnel (will provide an immediate supervisor who is fully credentialed as a school counselor which process the Pupil Personnel Services Credential with Advanced Authorization in School Counseling and Child Welfare and Attendance with two years of experience) for the intern. 5. The District will not displace appropriately certified employees through the use of any intern. 6. The District has on file procedures for assigning and paying support personnel assigned to the intern. 7. The District s rational for implementing and participating in the CSULA Internship Credential program is to provide appropriately trained personnel to meet the educational needs of the students within the district. The district has on file a statement regarding its inability to fill the necessary positions with qualified certified employees for which this internship credential is being implemented. (The exclusive representative of the certified employees in the credential area for which this internship agreement is directed agrees/disagrees (circle one) with the justification noted above). We look forward to participate with you in this Internship Credential Program. Please do not hesitate to contact me at (phone number) if I can provide any further information regarding our participation in the program. Sincerely, Name: District Level Administrator Title: Name: Exclusive Representative of Certified Employee Title: 6

8 Appendix B: (Sample letter of appointment of job offer) (DISTRICT LETTERHEAD) Date [Insert University Faculty Name, CCOE, CSULA] Division of Special Education and Counseling 5151 State University Drive, KH C-1064 Los Angeles, CA Dear [Insert University Faculty Name]: I am writing in order to request that (name of candidate) be granted admittance into your School Counseling Internship Credential Program. Our district has executed a letter of agreement with your Charter College of Education and is offering an assignment as a school counselor to Mr. /Ms. (name) to be effective (specific date to specific date). Mr. /Ms. will perform school counseling responsibilities for at least fifty percent of his/her assignment under the supervision of a qualified credentialed counselor. The district will also create an Internship Committee composed of the necessary people in accordance with your guidelines. Additionally, the district will release Mr. /Ms. for visitations one day per month and other required program meetings as appropriate. Should you require additional information or if I may be of further assistance, please let me know. Sincerely, (Appropriate District or Site Administrator) 7