ࡱ> $- bjbj;@;@ E Y*dY*djJ J 8,&F#9999ZD$%%%%%%%$e(+|%Hr"HH%999% HF99% H% 9=\5gF %%0& ++ n+:$P  X%%&HHHH+J U: Department of Counselor Education and Counseling Psychology college of education   EMBED Word.Picture.8  SCHOOL COUNSELING SUPERVISION AGREEMENT BETWEEN DEPARTMENT OF COUNSELOR EDUCATION AND COUNSELING PSYCHOLOGY (CECP), MARQUETTE UNIVERSITY AND COOPERATING SCHOOL: Name of school Address Address of school- on one line Telephone school telephone number on one line FOR THE CONDUCT OF A SUPERVISED SCHOOL COUNSELING INTERNSHIP, COUN 6990 The above-named school agrees to provide the facilities, student work opportunity, instruction, and supervision necessary to properly conduct a school counseling internship experience for the student named below and according to the guidelines described in the Department of Counselor Education and Counseling Psychology Handbook for Counseling Practicum/Internship and the Clinical Affiliation Agreement. The student named below will complete (identify the number of hours to be completed) hours internship at this school while under the named Supervising School Counselor listed below. Name of Internship Student Your name Inclusive Dates of Internship List specific dates of experience (Month/Year) Principal _______________________________________________ Principal name Signature Date Supervising School Counselor _______________________________________________ Supervisor name Signature Date Internship Student _______________________________________________ Your name Signature Date Coordinator of School Counseling CECP տƵ _______________________________________________ Alan Burkard, Ph.D. Signature Date     Rev. 2017 SCHROEDER HEALTH COMPLEX, 150 P.O. Box 1881 MILWAUKEE, WISCONSIN 53201-1881 TELEPHONE (414) 288-5790 RSTUlmnopxocococococZocQch5>*CJhj5>*CJh ~h$5>*CJh6 5>*CJh ~h$5CJhh6 CJhh$CJh ~h$CJh$5>*CJaJjhUjjE hCJUVhjHhUhCJOJQJjhCJUmHnHuhh:CJOJQJaJhhCJaJh=RTpq  $ L | } ~     1$gd1$^`gdq 1$^gdlgd_$a$gd $1$a$gd$a$gd   # $ , - K L V { | } ~ i s  5 \ úٮٮ{qjccc\ h5CJ h6 5CJ hd5CJh ~h25CJh>M 5>*CJhd5>*CJh ~h$5>*CJh ~h>M 5CJhh5CJhh ~hq5CJhh ~5CJ\h ~h$5CJ\h ~h_5CJ *h/'h/'5CJh h>M 5CJh ~h$5CJh$5>*CJ!\ ]       2 ; < = > ] k p ~ xocVcOoxo hCJh *hJh${>*CJh *h${h${CJhh${h${CJh${h>M 5CJ h${5CJh${h${5CJh *h${h${5CJh${h${5CJh ~h>M 5CJ h ~5CJh ~h$5CJ hw5CJ hd5CJ h>M 5CJ h2X5CJ *h/'h2X5CJ hc5CJh ~h ~5CJ < = >  N o p q F  gd>M   @ ^`@ gd${  gd${@ `@ gd${gd${gd${`gdgd${gd${  N P _ ` o p q ijkmպĺΒyrhahUMIh jh Uh ~h{5CJ\ h2I5CJh ~h$5CJ h5CJ h>M h>M h$CJ *hzh${5CJh ~h${5CJh${h${5CJh" *h${h${5B*CJhphh${h${5CJh${h>M 5CJ h${5CJh${h${CJh${h${0J5CJh${h${CJh *h${h${CJhFjlmoprsuv @ ^`@ gdfmnpqstvwùùùùùh ~h{5CJ\h/'h ~hCJaJhCJOJQJhBhCJOJQJhCJaJh/'CJaJhJCJaJh ~h/'CJaJh jh UC0P&P:pBP/ =!"#$% Dp)4Dd !tJ  C A? 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