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Thecentervirtualacademy-ramhp
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Registration Form
Attendee Registration form
Candidate
Candidate
Option1: ONLY Current RAMHP Interns
Option 2: Request for Graduate Level Internship: School Based Mental Health Professionals (RAMHP program)
First Name
Last Name
Email
Cell Phone
Level of education
Level of education
Highschool
Community College
College/University student
College/University graduate
College/University Student
College/University Student
Freshman
Sophomore
Junior
Senior
Geographic area of interest (rank preference)
Geographic area of interest (rank preference)
North County (Dinuba, Cutler-Orosi, Yettem, Woodlake, Exeter, Farmersville)
Porterville
Tulare
Visalia
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Transcript
Country
Country
United States
State
State
N/A
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
City
Password
Cell Phone
How did you learn about internship program?
How did you learn about internship program?
The RAMHP Virtual Academy
Agency Listing from my Graduate Program
Referenced by Peer/Colleague/Friend
Searching/Researching Online
Social Media Marketing
Other
Other
What Graduate Program are you currently enrolled in
What Graduate Program are you currently enrolled in
Boise State University
Cal Baptist University
Campbellsville University
CSU Bakersfield
CSU Fresno
CSU San Bernardino
Grand Canyon University
Kentucky University
National University
Palo Alto University
Touro University
UMass Global
Walden University
Other
Other
Are you able to meet the minimum requirement of committing to two full semesters (January through December OR August through May) for the continuity of care of our clients?
Are you able to meet the minimum requirement of committing to two full semesters (January through December OR August through May) for the continuity of care of our clients?
Option 1 : January through December
Option 2: August through May
Interns participate in a mandatory two-hour group supervision every Friday morning for training, consultation, and case staffing. Are you able to dedicate intern hours on Fridays (8-12pm)?
Interns participate in a mandatory two-hour group supervision every Friday morning for training, consultation, and case staffing. Are you able to dedicate intern hours on Fridays (8-12pm)?
Yes
No
Do you hold a Master of Social Work (MSW)?
Please select
Yes
No
Are you able to meet the minimum requirement of committing to a full academic school year (Mid August through May) for the continuity of care of our clients? Note: You can intern/gather hours beyond one school year.
Please select
Yes
No - I would like more information.
Do you plan to enroll in a master's level social work (MSW) program AND be able to commit to a minimum of a full academic school year (Mid August through May) for the continuity of care of our clients?
Please select
Yes
No - I would like more information.
Please provide the name of your university
Which program (MSW and/or PPSC) and at what university?
Current Cohort:
Current Cohort:
Cohort 3
Cohort 4
Cohort 5
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