The mission of Counseling Services Training Institute is to offer affordable therapy while also providing practicum and internship students with quality supervision and training. The CSTI experience includes personalized clinical training as well as private practice management skills. If you are interested in joining us, please use the button below to complete your application today. After reviewing your application, one of our clinical supervisors will reach out to see if CSTI is the right fit for you.

Application for Internship

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

Ok to leave VM

Yes

No

Ok to Text

Yes

No

Date of Birth

MM

DD

YYYY

School Attended

Date Graduated

MM

DD

YYYY

Have you ever been convicted of a criminal offense?

Yes

No

If YES please explain.

Have you ever been found guilty of any ethics violations?

Yes

No

If YES please explain

I understand and give my consent to a background check prior to my acceptance into Counseling Services Training Institute

I Accept

What are your areas of interest and/or desired populations for internship. Additionally, please describe your school’s requirements regarding internship hours?

Can you tell us a bit about how you believe you relate to others?

Can you describe any biases, vulnerabilities, or limitations that may impact your work with any certain populations?

With which theoretical foundations do you feel you are most closely aligned?

info@counselingservicesti.com
(360) 562-9262

1157 3rd Ave. Suite 100
Longview, WA 98632

Practicum and clinical internships

COunseling Services Training Institute, pLLP