Supervisor Application

Yorkville University offers the Master of Arts in Counselling Psychology (MACP), which is designated in the province of New Brunswick and is delivered online.
Supervisor Application​

Basic Information

Do not use abbreviations. Please write out the province/state name in full.
Professional Association/Affiliation
Professional Standing

Clinical Supervision Information

Do you have one full year of clinically-supervised experience in post degree?
What supervisory role will you play in this practicum?

External Supervisor

You have selected External Supervisor, please identify the person with whom you will have regular weekly or bi-weekly contact:

Will you be supervising more than one Yorkville University student concurrently?

Ontario Practitioners

Which regulatory college are you a registrant of?
Ontario Clinical Requirements
Have you completed 30 hours of directed learning in providing clinical supervision?
Please indicate your directed learning activities:
Select all that apply
Do you understand CRPO’s definitions of clinical supervision, clinical supervisor and the scope of practice of psychotherapy?

Supervisor Agreement

I acknowledge that I am not the Practicum Student's direct Employment Supervisor and/or current therapist (i.e., refraining from dual relationships as outlined in the Supervisors Practicum Guide)
I agree to uphold the requirements and procedures outlined in the Supervisors Practicum Guide.

All potential supervisors are required to provide a copy of (1) current CV or Resume and (2) registration/certification/licensure document to be reviewed and approved by the Department of Field Training, even if they have provided it previously. Please email these items to our Practicum Liaison [email protected] in order to complete the application process.

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