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For Office Use Received By Date Fresno Family Counseling Center Application for Coun 238 Practicum RETURN TO FFCC 3718 N. FIRST STREET Phone 559 229-3085 Address City/Zip Email Home Phone Work Phone Other Phone MEET WITH YOUR FACULTY ADVISOR PRIOR TO COMPLETING THIS FORM. 1. Preferred Semesters Fall 2009 Spring 2009 Summer 2010 Fall 2011 Spring 2011 2. Are you a Classified Graduate Student Yes No Coun 208 230 and 232 are prerequisites for this course. Coun 231 must be taken prior to or concurrently with Coun 238. Coun 231 is NOT offered in the Summer. 3. When did/will you take Coun 208 Practicum Who was/will be your instructor Please note that your instructor may be contacted prior to admittance and that instructor recommendation is required for Summer section* Enrollment in this course is limited and admittance is based on date of application Coun 208 instructor recommendation and availability. You will be contacted by letter at the end of the semester prior to being admitted* You will be required to maintain professional liability insurance in the amount of one million dollars to participate in this course. 1. Preferred Semesters Fall 2009 Spring 2009 Summer 2010 Fall 2011 Spring 2011 2. Are you a Classified Graduate Student Yes No Coun 208 230 and 232 are prerequisites for this course. Coun 231 must be taken prior to or concurrently with Coun 238. Coun 231 is NOT offered in the Summer. Coun 231 must be taken prior to or concurrently with Coun 238. Coun 231 is NOT offered in the Summer. 3. When did/will you take Coun 208 Practicum Who was/will be your instructor Please note that your instructor may be contacted prior to admittance and that instructor recommendation is required for Summer section* Enrollment in this course is limited and admittance is based on date of application Coun 208 instructor recommendation and availability. 3. When did/will you take Coun 208 Practicum Who was/will be your instructor Please note that your instructor may be contacted prior to admittance and that instructor recommendation is required for Summer section* Enrollment in this course is limited and admittance is based on date of application Coun 208 instructor recommendation and availability. You will be contacted by letter at the end of the semester prior to being admitted* You will be required to maintain professional liability insurance in the amount of one million dollars to participate in this course. 1. Preferred Semesters Fall 2009 Spring 2009 Summer 2010 Fall 2011 Spring 2011 2. Are you a Classified Graduate Student Yes No Coun 208 230 and 232 are prerequisites for this course. Coun 231 must be taken prior to or concurrently with Coun 238. Coun 231 is NOT offered in the Summer. 3. When did/will you take Coun 208 Practicum Who was/will be your instructor Please note that your instructor may be contacted prior to admittance and that instructor recommendation is required for Summer section* Enrollment in this course is limited and admittance is based on date of application Coun 208 instructor recommendation and availability. .

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