Applied Practice II-Counseling 545/523
Approval for Additional Practicum Hours
Please see: Extra Hours Policy
Student requesting Extra Hours:____________________________________
Date:_____________________________________
Date required 100 hours were completed:___________________________
Placement:______________________________________________________
Site Supervisor Signature______________________________________________________ Date:______________
Individual Faculty Supervisor Signature_________________________________________ Date:______________
Group Faculty Supervisor Signature_____________________________________________ Date:______________