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Get CSUB COOPERATIVE AGREEMENT FOR CSUB - Csub

E) (for K-12 only) YES NO Professional Liability Insurance Paid and Current? (circle all that apply) CSUB Insurance? Added Insurance? YES YES NO NO (mandatory prior to start of intern hours) Through which organization(s)? II. SITE INFORMATION Name of Site: Name of Site Supervisor: Title: Degrees and Credentials: How many years in current position? If K-12, how many years as a PPS counselor? Mailing Address: City: Zip: Phone(s): E-mail Address: Fax: III. AGREEMENT Please com.

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